Category: Uncategorized

Cong Markey Briefs Health Care On Debt Ceiling Discussions

Yesterday, Congressman Edward Markey conducted a briefing for members  of the health care and health research communities on the debt ceiling discussions and the possible impact on these sectors going forward.   Although the Super Committee has received a significant amount of the attention, the debt discussions will actually occur in three steps.

The first step will include a cut of $900 billion. These cuts must be effective on 10/1/2011. Medicare and Medicaid cannot be included in this first cut, but all other federal spending including defense and non defense can be considered.

Step 2 is the Super Committee, comprised of six Senators and Representatives. The budget target for this Committee is $1.2 trillion.  Their work must be done by Sept 23rd and if recommendations are made, must be voted on by Dec 23rd.  The bring a proposal forward will require 7 or the 12 votes.  In Senate, a simple majority vote will be needed to pass.

According to Markey, this group “will go from 0 to 60 miles per hour” to meet the September 23 deadline and for this group “everything is on the table.”    This group has broad latitude to propose changes in benefits or  program design in terms of federal entitlements, including Medicare and Medicaid benefits and program design;  eligibility and contributions to Social Security;  defense spending, tax rates, “loopholes”  and contributions, etc.  Markey indicated that all of the Republican appointees have pledged to support no new revenues, which will make this Committee’s work more difficult.

Should the Super Committee not reach consensus, the process will move to Step 3, which would be a an automatic cut on 10/1/13 of $1.2 trillion in spending, 50% of which would come from “security” and 50% from non security spending.  Under this scenario, the sole restriction is that Medicare cuts would be set at 2%.

Congressman Markey engaged the group in discussing:

What is you message to the Super Committee?

What would you recommend that Super Committee members do if there are no revenues and only cuts to achieve the goal?  Is moving to Step 3 preferable to this scenario?

Is a Step 3, i.e. 2% cut in Medicare in Oct 2013 sustainable?

Question to Home Care:   What is your message to Congress on this?

Please Circulate Physician Survey on Face to Face Requirement

The National Association for Home Care and Hospice is seeking help from home health agencies in getting physicians to complete a very important short survey that will help inform federal government policymakers about important issues related to CMS’ face-to-face encounter requirement. NAHC is meeting with CMS leadership in the coming weeks to discuss the impact of the face-to-face requirement, and in order to effectively stress the home care industry’s position on this issue, they need substantive data from physicians. P

The 10-question survey is only for physicians and will take less than 5 minutes of a physician’s time to complete. The deadline to submit the survey is Friday, June 24 at the close of business!  To ensure the accuracy and confidentiality of this survey, NAHC has partnered with an independent research company which will collect all responses and keep them completely anonymous. It is very important for the credibility of this survey that physicians be informed that the benefit to them for participating in this survey is to make sure their opinion is heard, whatever that opinion may be.

Click here to download the survey information for physicians.

Click here to down load a page explaining the survey in more detail.

Introducing the New Alliance Career Center

We’re very excited to announce the launch of the new Alliance Career Center, catered specifically to employers and job seekers in Massachusetts’s home care community.

The Career Center replaces our old Job Board. The new module includes a vastly-improved interface for employers with the ability to “feature” your most important listings and to search resumes of job seekers. Job seekers also have the ability to post their resumes online and receive notification of new openings.

In short, it’s a full-function, pro-actively marketed Career Center that gives a much better value to employers and job seekers alike. Features include:

For Employers

  • Create a FREE Employer Profile
  • Reach a targeted audience of local home care professionals
  • Find the most qualified candidates
  • Take advantage of affordable pricing less than half the cost of other job websites
  • Manage applications through your website or the Alliance Career Center
 For Job Seekers

  • Create a FREE Job Seeker Profile
  • Access exclusive job opportunities from top employers
  • Find local and regional home care jobs
  • Get notified immediately of new openings
  • Quickly apply for open positions online
  • Post your resume anonymously

Job listings are competitively priced and begin at just $175 for a 30 day job.  Employers may further reduce their costs by purchasing packages of five or ten jobs, or by becoming members of the Alliance.  Posting your resume is completely free of charge.

To get started…

Create a FREE Employer or Job Seeker profile and start posting your resume and open positions today!

Return to www.thinkhomecare.org.

Care Transitions Program Part of Partnership for Patients

Centers for Medicare and Medicaid Services Administrator Dr. Don Berwick and US Health and Human Services Secretary Kathleen Sebelius announced a massive initiative and federal funding opportunity dubbed the “Partnership for Patients.”

This billion dollar commitment from the federal government will be split between two goals:

  • Keep patients from getting injured or sicker. By the end of 2013, preventable hospital-acquired conditions would decrease by 40% compared to 2010.
  • Help patients heal without complication. By the end of 2013, preventable complications during a transition from one care setting to another would be decreased so that all hospital readmissions would be reduced by 20% compared to 2010.

Home health agencies will be most interested in the Community-Based Care Transitions Program, which will spread $500 million in funding to community-based organizations partnering with eligible hospitals for care transition services that include timely, culturally, and linguistically-competent post-discharge education, medication review and management, and patient-centered self-management support within 24 hours of discharge.

Recently, the solicitation and application have been released after months of waiting and the Home Care Alliance is continuing to encourage eligible agencies that qualify as Community-Based Organizations (CBO’s) to partner with hospitals, ASAP’s, and other providers to submit an application.

Here is the list of pertinent documents for this program:

Agencies that have any questions regarding this program can contact the Home Care Alliance.

Return to www.thinkhomecare.org.

Talking to a Dying Patient

Atul Gawande, MD of Brigham’s & Women’s Hospital discusses his experience in talking with hospice patients and offers  advice on how to approach difficult end-of-life issues.

Return to www.thinkhomecare.org.

Mass. Medical Home Initiative Launched

Massachusetts is moving to the head of the pack in terms of service delivery realignment with the release on July 9th of the Patient Centered Medical Home (PCMH) RFR.    As many as 50 practice sites could be selected to participate in a model that includes enhanced payments for care coordination and care management and shared savings to be calculated based on experiences of a control group of practices.

The PCMH demonstration, which will be three years in length, involves both MassHealth and several commercial insurers; although according to HHS Secretary Judy Ann Bigby,  it is far more “Medicaid centric” than had been envisioned in earlier development stages.

With tremendous focus on each PCMH influencing what happens to the patient when she/he is not in the physicians office, the PCMH offers partnership opportunities for home health agencies. The RFR states that although  all PCMH practice sites must provide care coordination for high risk patients, these services can be handled through a contractual relationship – as long as it clearly reflects a team approach.  Additionally, with the shared savings component, practices will have a real financial stake in keeping patients out of hospitals and ERs.

Since small physician practices still dominate the  market in Massachusetts, the states hopes to see a good representation of these in the mix of selected PCMHs.  Home health agencies should be prepared to discuss this new opportunity with physician offices and to offer support and services to assist in their applications.

The full RFR is to be found on the state’s competitive bidding site Comm-Pass (search for (1LCEHSMEDICALHOMES).  General information about the project, including some dates and times of informational webinars to be held next week, can be found on the EOHHS medical Home page

Free Readmission webinar offered as part of HHQI

Steve Landers, MD, MPH, Director, Center for Home Care and Community Rehab. at Cleveland Clinic will present a free webinar on Hospital Readmissions and the Role of Home Care on June 30th, Noon – 1 PM.  On the agenda is  a sharing of  best practices for the use of home health care in patients who have chronic care needs or high-risk patients.  Space is limited, but interested persons can register now at the HHQI website.

Return to www.thinkhomecare.org.

QCC Sets and Reviews Goals Scorecard

The Massachuetts Quality and Cost Council (QCC)  has begin to track progress against six goals established by the Council pursuant to their charge as established in Chapter 58 of the Acts of 2006.  The Goals Scorecard includes measures around improving the screening for and management of chronic illness in the community and developing new measures to track progress in adhering to patients’ wishes at end of life.  The latter will include tracking – as recommended by the state’s Expert Panel on End of Life care – the percentage of hospitals,  SNFs and home health agencies with palliative care programs.  The Advisory Committee to the QCC will seek input on these goals, and the associated measures,  at their May meeting.  What is your feedback?

Chronic Care Management And Home Care

Yesterday more than 40 Alliance members participated in a workshop on making the business care for home care to be at the enter of efforts to introduce better management of chronic illness to the US health care system.   Beth Hennessey of Baptist Home Care provided the agency template for matching the core competencies of home care to the policy and programmatic changes that are envisioned in federal health care insurance and delivery system reform.

One take away message is that Massachusetts may see opportunities in this area even quicker than the rest of the country as this state is moving into Phase II of reform (system realignment) while most other states are still on Phase I (universal coverage).   An immediate challenge to home care to deliver services in a new and different way may well present itself when the state releases its RFP – this spring or summer – for a broad Medical Home pilot.

All home care agencies should be familiar with the state’s plans – as described in their Patient Centered Medical Home Framework for Design and Implementation. Help physicians to see how a new home care partnership can make a medical home work.

– Pat Kelleher

Return to www.thinkhomecare.org.

March on Washington Part II

A few take away thoughts from the few days spent in DC:

Although no elected representatives or staff voiced it, there is some sense of health care reform fatigue among Capitol Hill staffers.  Since our issues are not major changes to the bill, we had a more receptive audience.

Senator Kerry gave the most impassioned defense of health care reform of all Senators we heard from at NAHC’s Senate Breakfast.  He commended provider input and acknowledged that much of the difficult work is yet to be done. His speech in full is on our You Tube Channel.

Congressman McGovern remains among the greatest supporters of home care in the US Congress. He is so, because home care leaders in his district got to him right after his first election and passage of the BBA of 1997.   His unwavering support shows the power of relationship building and the value of developing support among newly elected representatives.

It was great that we were able to meet Senator Scott Brown if only to start educating him about what we do. See previous comment above.

There are many opportunities for home care in the reform bill; but is going to be up to us to make sure that they come to pass.  All hands are going to be needed on deck.

Get involved and stay involved.  Your voice is going to be needed.

– Pat Kelleher

Return to www.thinkhomecare.org.