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Frustrated by disengaged and unproductive employees?  Keynote speaker David Rendell will offer a unique take on the issue during his New England Home Care Conference & Trade Show keynote address “The Freak Factory: Making Employees Better by Helping Them Get Worse.”  Here’s a preview:

Research shows that most people are not committed to their jobs and the way we currently manage employees does more to harm than help, their performance. We think our employees are broken, treat them like they are broken, and then wonder why they don’t work. Instead of attacking people’s weaknesses, we need to find the strength that is hidden inside their apparently negative characteristics.

Rendell is a speaker, leadership professor, stand-up comedian and endurance athlete with more than 15 years of experience leading people and organizations. He is also the author of two books, The Four Factors of Effective Leadership and his latest, The Freak Factor: Discovering Uniqueness by Flaunting Weakness.

To learn more about Mr. Dendell — as well as the other speakers, presenters, programs, and exhibitors  at the conference — just download the brochure and register today.

And don’t forget that all Home Care Alliance of Massachusetts who register for the conference before April 13 will be entered to win one of two $50 chips to use as the casino!

Health reform in Massachusetts is an ever moving river of change.   New legislation is expected within the month from both the Massachusetts Senate and House offering plans for more and faster delivery system reform.  In February,  the state began moving at an even faster pace to implement legislation from last session entitled “An Act to Promote Cost Containment,  Transparency and Efficiency in the Provision of Quality Health Insurance for Individuals and Small Business.”

Ostensibly, this new law is intended to guide and govern the establishment of selective or tiered (and presumably less expensive) health plan offerings.  The law charges  the Massachusetts Department of Public Health with promulgating regulations requiring the uniform reporting of a standard set of health care quality measures by each “health care provider facility, medical group, or provider group.”   The idea behind this new and potentially quite expansive quality data collection (and reporting) is to allow business who are buying (and consumers who are choosing) these selective network plans to make decisions based on comparable quality measures.  These quality measures may also eventually aid state government in measuring the performance of various and soon to be operating integrated healthcare systems, such as ICOs, ACOs, and PCMHs.

Not counting ex officio government officials, the Committee has only six members who are charged with selecting these measures.   While the Committee has significant discretion, the enabling legislation established some priorities and data sets that they must consider, including – for hospitals- using some data from the CMS process measures, HCAHPS and HEDIS.

At their most recent meeting, the Committee considered the 170 data elements contained in these three hospital measure sets and began narrowing it down  – based on evaluation of validity, reliability and practicality (ease of accessing)  – to 30 or 40 elements that may emerge as strongly recommended for inclusion in what would become a standard quality measure set for the state.

The legislation also instructed that the Committee consider as quality improvement priority areas: care transitions and care coordination, behavioral health and post acute care.  The Committee has yet to tackle these areas and has been clear that their areas of initial focus remain hospitals and community health centers.   Although the Committee did in March solicit public opinion as to others measures to consider beyond the hospital ones mentioned above (and the Alliance did send in comments), as the Committee is structured only recommendations will be truly considered that are put forth by one of the six committee members.

This Committee is moving quickly.  Post acute care and care transitions are on the agenda for their April 12^th meeting in Boston.

Once again last week, home care was in the news in a major press statement from CMS and on national television.  Unfortunately,  the stories weren’t about the patients and families receiving incredible comfort and care from our skilled teams, or about hospitalizations prevented,  or healing advanced.  The news was about the indictment of Dallas physician Jacques Roy –  accused of running a 485 factory that “certified more Medicare beneficiaries for home health services and had more purported patients than any other medical practice in the United States.”  Dr. Roy allegedly certified or directed the certification of more than 11,000 individual patients from more than 500 HHAs for home health services during the past five years, for services totaling $375 million. Five people have been indicated and Medicare payments to 78 agencies have been suspended.

The Home Care Alliance of Massachusetts has tried to lead when it comes to ensuring an industry that is ethical and trusted by patients and referrals sources. Several years ago, we added a Code of Business Ethics to our membership application. We have taken a strong stand against unchecked growth, supporting language in the Affordable Care Act that gives the federal EOHHS Secretary to impose temporary moratoriums in areas that have sufficient coverage and unsustainable growth. In 2010, we suggested in a letter to Secretary Sebelius that the the 25% growth of new agencies in four years in Mass deserved some EOHHS attention.  We have expressed concerns to federal and state regulators about the deemed accreditation process, whereby new agencies gain entry into the market, and about the need to make it more rigorous, We have published – mostly for our referral partners in physicians offices and assisted living – several pamphlets (“Keeping It Legal”)  on referrals, kickbacks and other prohibited practices.

This week we in response to the Texas news, the Visiting Nurse Assoiciation of America called on CMS “to use its authority to put a temporary moratorium on home health until better controls to prevent waste, fraud and abuse can be put in place.   Enforcement,” VNAA said, “is not enough.”

Next week, the Board of Directors of the Home Care Alliance will be meeting.  What do the members think should be our position on the “Texas situation?”

 

This past week, Helen Siegel, our Director of Regulatory and Clinical Affairs retired after 17 years of supporting our member agencies in all issues clinical, QI,  and regulatory.  Helen took more calls than anyone in our office and responded to any and all questions sent her way.  Her knowledge and presence will be missed.

As part of her send-off, her peers at the Alliance prepared this for her:

 

Twas the night before Christmas, At the Alliance, Park Square
Not a creature was stirring, was noone there?

No stockings were on the desks or the walls
Not even the blue tree with disco glitter balls.

No TPL calls, no help me to start
No meetings, no minutes, not a single faxed chart.

The staff were all quietly digesting  the news
Helen’s departing, who’ll fill her shoes?

No visions of sugar plums, no candy canes
Can sweeten the blow, can help ease the pain.

When all appeared lost, Tim said, I have a plan
We’ll write to Santa, yes, Santa’s our man.

We’ll ask him to find someone…not naughty but nice
Who can take all these calls, and give good advice.

And if he could, perhaps someone who knows,
face to face and QI, and maybe the SCOs.

The email was sent and then we waited and waited
I guess even we knew our wish too inflated.

For even for Santa the task proved too rough
A replacement for Helen, that’s just not his stuff.

Skills like these, well the fact that years to hone,
Good thing Helen still has her cell phone!

But tis the season of miracles and light
One by one, the eight candles bring hope, and burn bright

So with hope for the future, and a fate we can’t fight

Happy Retirement, Helen
And to all, a good night! 

Happy Holidays and Peace and Joy in 2012.

 

 

 

Anyone interested in a little insight into CMS under Dr. Don Berwick and what the legacy of  his short tenure might be can find a lot to consider in the online Health Affairs post:  “Now Departed From The Centers For Medicare And Medicaid Services…” written by Harris Meyer.    The article looks at Berwick’s efforts to both transform the health care delivery system, as well as the CMS agency and the 5,400 people it employs.    “We’re working on the agency culture and habits,” he said in an interview between meetings.  “We’re seeking boundarylessness, speed and agility, unconditional teamwork, innovation, and customer focus. ”  All indications are that the large bureaucracy was beginning to respond.

Interestingly, Berwick’s “that’s democracy” quote comes not in response to the partisanship in Washington DC that laid ruin to any chance he had at a permanent appointment.  Berwick used the phrase in reflecting on the outpouring of (mostly negative) comments received at CMS from health care stakeholders with the release of his preliminary proposal on Medicare Accountable Care Organizations.  “What happened is what should have happened,” he said. “We took our best shot, and smarter people than we are responded. That’s democracy.”

Democracy indeed. Read it for yourself and decide.

The Centers for Medicare and Medicare Services (CMS) announced yesterday that they are offering $1 billion in grants to providers and payers who propose “the most compelling new ideas to deliver better health, improved care and lower costs” for the Medicare, Medicaid and CHIP populations. CMS noted that priority will be given to projects that can begin within six months after the award is granted.

CMS has identified three primary objectives of the Innovation Challenge funding:

1. Engage a wide variety of innovation partners and test new care delivery and payment models that promote better care, better health, and reduced costs;
2. Identify new models of workforce development, deployment, education, and training that support new models; and,
3. Support innovators who can rapidly deploy (within six months of award) through new ventures or expansion of efforts to new populations, in conjunction with other private and public sector partners.

The Home Care Alliance is hosting our own members Innovation Showcase on December 7th at the John F. Kennedy Library. At this event, seven member agencies will present their successful work in agency transformation in areas of care transitions, readmissions reductions,  end of life care,  and more.   Senator President Therese Murray will be one of the invited guest speakers.

Join us on December 7th and be inspired.

Letters of Intent for the CMS program are due December 19th.