The next Home Health, Hospice & DME Open Door Forum is scheduled for Wednesday,, March 5, 2014 at 2:00 PM
To participate by phone:
Dial: 1-800-837-1935 & Reference Conference ID: 71246014
Proposed Agenda
1. Opening Remarks
2. Announcements & Updates
For details visit the ODF Website
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A national trade association of health insurers, America’s Health Insurance Plans, is strongly protesting a new round of proposed cuts to 2015 Medicare Advantage payment rates. Preliminary estimate of the combined effect of the Medicare Advantage growth percentage and the fee-for-service growth percentage is estimated to be -1.9 percent,” CMS said Friday in releasing their proposed rule.
The Bundled Payments for Care Improvement initiative, developed by the Center for Medicare and Medicaid Innovation, has been reopened for additional models focusing on post-acute.
Through the initiative, organizations partner together and enter into payment arrangements that include financial and performance accountability for episodes of care. There four models of bundled payment being tested, but models 2 and 3 are areas where home health agencies can play a central role.
More information on the program and the “open period” where new proposals can be submitted is available here. In order to be considered for participation in the Bundled Payments for Care Improvement initiative, all open period submissions must be submitted by April 18, 2014.
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The Home Care Alliance’s annual Financial Managers Conference was held last week at the Conference Center at Waltham Woods. The conference included presentations on benchmarking and operational efficiencies (from principals from BKD and McBee Associates), as well as a presentation from Emily Brower, the Director of ACO programs at Atrius Health. Atrius Health is one of five Pioneer ACOs in Eastern MA. Ms Brower’s presentation was summarized in Home Health Technology Report by Tim Rowan, who was also at the conference to present on IT Trends.
Ms Brower talked frankly about their need to manage costs, their dependence on their home care agency VNA Care Network/VNA of Boston and their progress in creating truly integrated plans of care. Read Tim Rowan’s summary here.
For more news like this follow the Alliance (@thinkhomecare) and Tim Rowan on Twitter (@TimRowan).
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Congress is working in the final days before the holiday recess on a long-term Medicare Sustainable Growth Rate (SGR) process and an amendment to that process could delay the impending rebasing cut to home health care.
The Alliance is asking that agencies and advocates contact their Member of Congress TODAY to educate them about the amendment and what it means for Medicare home health agencies. 
Senator Debbie Stabenow (D-MI) has offered an amendment that essentially delays the effects of rebasing so that CMS can hopefully adjust their methodology with updated and more accurate data. Educating the Massachusetts Congressional Delegation is crucial to getting support for the amendment as there is so much happening in the final two days of activity.
More information and a prepared email message is available on HCA’s Legislative Action Network and it only takes a minute to log on and add your voice to this critical push to delay a damaging 3.5% cut per year over the next four years.
We also urge members to call the offices of your Congressional representatives directly using the message below as a guide. Simply call the main switchboard at (202) 224-3121, request a transfer to the office of your Congressional representative, and ask to speak to the individual from that office that is responsible for health policy.Here is the text of the message to Congress if you choose to call:
The U.S. Centers for Medicare and Medicaid Services (CMS) has finalized a rule imposing unprecedented Medicare home health reductions under a process called “rebasing.” All told, the impact on providers will be a $200 million cut in each of the next four years.
We are asking for your support in backing an amendment from Senator Debbie Stabenow as well as any corresponding effort in the House to amend the Medicare Sustainable Growth Rate (SGR) process.
These are the largest cuts to home health in decades, and they will cause many agencies to close their doors, especially if these cuts are compounded by Medicare reductions via the continuing budget resolution. Such cuts are counter-productive at a time when health reform relies on cost-effective care at home to serve vulnerable citizens.
CMS’s rebasing cuts were finalized on November 22 and go into effect on January 1. This leaves little time to delay these disastrous cuts and compel CMS to conduct a more fair, accurate and thorough analysis of its fiscal assumptions.
The data is clear. Many Medicare-certified home care providers are already operating in the red across all sources of payment. These new cuts – scheduled to be compounded for each of the next four years – will cripple the industry and create barriers to care. Yet, despite similar trends across the country, CMS concludes that draconian rebasing reductions are needed to eliminate positive margins in home health. CMS’s math simply does not add up.
Many in Congress agree. A bipartisan letter sent to CMS raised strong concerns, stating that the rebasing methodology relies on “incomplete data and analysis that results in the under-counting of home health agencies’ costs per episode of care, and an inappropriately high rebasing adjustment.”
Home care providers nationwide thank you and your colleagues in Congress for your strong stance on rebasing and we ask for your continued active engagement supporting Senator Stabenow and others to delay rebasing and initiate a more rational approach from CMS.
Thank you.
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Several healthcare industry news outlets, including Modern Healthcare, are reporting that CMS is extending the deadline that providers are required to show Stage 2 “Meaningful Use” criteria of electronic health records (EMR).
The overall deadline is delayed for one full year and, according to Modern Healthcare, Stage 2 of the CMS incentive program to encourage EMR adoption will be extended through 2016. Stage 3 won’t begin until at least fiscal year 2017 for hospitals and calendar year 2017 for physicians and other eligible professionals that have by then completed at least two years at Stage 2.
CMS and the Office of the National Coordinator for Health Information Technology at HHS say that the delay is intended help both federal entities focus on helping providers meet Stage 2’s demands for patient engagement, interoperability and information exchange, as well as use data collected during that phase to inform policy decisions for Stage 3.
The proposed rules relative to the requirements providers must meet for Stage 3, as well as the 2017 Edition of standards that health IT developers must build and test their systems to match, are expected to be released in the fall of 2014 .
The Modern Healthcare article noted that the program, created under the America Recovery and Reinvestment Act of 2009, has paid out about $17 billion since January 2011, according to the latest CMS data.
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Earlier this year, the Alliance published two brochures regarding patient choice after a hospitalization or stay in other medical facilities.
We’re pleased to announce the publication of a Spanish translation of the patient-orientated version, “Your Care, Your Choice,” which reminds patients of their right to choose their own providers, and empowers them to report facilities that attempt to violate these rights.
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CMS is conducting a call on program manual updates related to the Jimmo v.Sebelius law suit on the CMS MLN Connects, Thursday, December 19th at 2-3pm ET. The program title is Program Manual Updates to Clarify SNF, IRF, HH, and OPT Coverage Pursuant to Jimmo v. Sebelius
To Register: Visit MLN Connects™ Upcoming Calls. Space may be limited, register early.
Agenda
On January 24, 2013, the U. S. District Court for the District of Vermont approved a settlement agreement in the case of Jimmo v. Sebelius, involving skilled care for the inpatient rehabilitation facility (IRF), skilled nursing facility (SNF), home health (HH), and outpatient therapy (OPT) benefits. “Nothing in this Settlement Agreement modifies, contracts, or expands the existing eligibility requirements for receiving Medicare coverage.”
The goal of this settlement agreement is to ensure that claims are correctly adjudicated in accordance with existing Medicare policy, so that Medicare beneficiaries receive the full coverage to which they are entitled. The settlement agreement sets forth a series of specific steps for CMS to undertake, including issuing clarifications to existing program guidance and new educational material on this subject.
As part of the educational campaign, this MLN Connects™ Call will provide an overview of the clarifications to the Medicare program manuals. These clarifications reflect Medicare’s longstanding policy that when skilled services are required in order to provide reasonable and necessary care to prevent or slow further deterioration, coverage cannot be denied based on the absence of potential for improvement or restoration. In this context, coverage of skilled nursing and skilled therapy services “…does not turn on the presence or absence of a beneficiary’s potential for improvement, but rather on the beneficiary’s need for skilled care.” Portions of the revised manual provisions also include additional material on the role of appropriate documentation in facilitating accurate coverage determinations for claims involving skilled care. Target Audience
Skilled Nursing Facilities; Inpatient Rehabilitation Facilities; Home Health Agencies; and providers and suppliers of therapy services under the Outpatient Therapy Benefit
National Government Service’s Home Health Open Door Forum: Ask-the-Contractor Teleconference (ACT) is scheduled for Tuesday, December 10, 2013 from 1:30-3:00 pm This teleconference will provide updates to the home health provider community and a forum for questions and answers. The ACT is an opportunity to speak directly to the contractor, so please have your questions ready for the contractors to answer!
Date: Tuesday, December 10, 2013
Time: 1:30-3:00 p.m. ET
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By: Jeanne M. Ryan, MA, OTR, MBA, CHCE
Executive Director VNA & Hospice of Cooley Dickinson
According to the Massachusetts Expert Panel on End-of-Life Care:
“What people want and need as the end of life approaches are things that have mattered to them throughout life, often now more intensely then ever: that their wishes and values are respected, that their symptoms are well controlled; that their dignity is maintained; and that they can spend as much meaningful time as possible with those they most love”.
And while 70 percent of Americans say they wish to die at home, surrounded by family, in Massachusetts the reality is exactly reversed: More than 70 percent die in hospitals or nursing homes, often spending their last days or weeks attached to high-tech life support machines. The choices that patients and their families make about care at this stage of life are extremely personal, but can only be made well if the full range of options is presented, explored, and considered with each patient individually. Continue reading “Guest Post: Making the MOLST of Your Life”
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