State Holds Health Payment Reform Info Session

Health care advocates and stakeholders packed and overflowed a large conference room meant to host an information session on the implementation progress of the new health care payment reform law.

Governor Patrick walked in mid-session and summed up the intent of the meeting where every state agency and department mentioned in the law was present to speak on their respective piece. The Governor explained that it took a lot of work to pass what he termed ‘a good bill’, but added that ‘now the real work begins.’ He said that it will take work on the part of government, providers, and stakeholders to ensure that the law is implemented effectively and the way in which it was intended.

To that end, Health and Human Services Secretary JudyAnn Bigby reported that the 11-member board of the Health Policy Commission, the main group charged with developing the policy necessary to implement the law, will be convened by November 5. The work of putting together other task forces and commissions, including those where the Home Care Alliance has the authority to name a representative, has already begun.

One of HCA’s victories in the legislation was the ability to name members on the Behavioral Health Task Force and the Commission to Review Public Payer Reimbursement Rates.

Other state agencies and their responsibilities are being reconfigured, including the Division of Health Care Financing becoming the Center for Health Information and Analysis. That group will be an independent state agency and so-called “pricing activities” relative to rate setting will move under the Executive Office of Health and Human Services.

The Alliance will provide updates as they become available and the state has an implementation website with more information at http://www.mass.gov/governor/agenda/healthcare/cost-containment/.

Return to www.thinkhomecare.org.

MassHealth To Hold Briefing on Primary Care Redesign

The Commonwealth of Massachusetts Executive Office of Health and Human Services, Office of Medicaid (MassHealth) will be hosting a town hall meeting specifically geared towards health care providers regarding the Primary Care Payment Reform initiative.  This is an opportunity for providers to interact directly with Dr. Harris and share their thoughts, comments, concerns regarding the initiative. The goals of the MassHealth Primary Care Payment Reform initiative are to improve access, patient experience, quality, and efficiency through care management and coordination, and to integrate behavioral health care with primary care. The proposed model is designed to support the delivery of primary care through practices consistent with a patient-centered medical home with integrated behavioral health services.

The first of four town hall meetings is set up to provide a general program overview which will be given by MassHealth Director Dr. Julian Harris. The details of this meeting are as follows:

Date: Wednesday, October 23, 2012

Time: 6:30– 8:00 PM

Location: Morse Institute Library

14 East Central Street, Natick, MA 01760

The web site below includes more information on this initiatives and information regarding upcoming provider town hall meetings.

http://www.mass.gov/eohhs/gov/newsroom/masshealth/providers/primary-care-payment-reform-initiative.html

NEW! Validated and Multi-factorial Falls Risk Assessment Tool

The Missouri Alliance for Home Care (MAHC) has developed a multi-factorial Fall Risk Assessment Tool (MAHC-10) that has been studied and recently validated. The MAHC-10 has been scientifically tested and the validation study published.  Agencies may now use just the MAHC-10 alone to meet the OASIS requirement. .

In a Press Release posted October 9, 2012, MAHC reports “Home health agencies will now be able to meet the OASIS requirements utilizing the MAHC-10 as an initial screen for fall risk… This single tool can be used with all patients, including bed-bound patients and those with severe mobility limitations, thereby meeting CMS criteria to mark a ‘yes’ response on M1910.”

Agencies may use the MAHC-10, including incorporating it into internal documents and computer systems, at no cost, however, Missouri Alliance for Home Care  requires that proper credit be given to MAHC and that the content is not modified in any way.   For more information visit the MACH website

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Alliance Members Talk Care Transitions, CON With State Survey Head

Madeleine Biondolillo, MD, the Director of Health Care Safety and Quality at MA Department of Public Health  informed home health executives this week that efforts by the state to support better care transitions may eventually become more deliberate – possibly by adding care transitions “compliance” to the state survey process.  In a discussing her Division’s plans with the executives,  Dr.  Biondolillo indicated a strong preference for “leveraging her Department’s regulatory clout”  to drive improvement in the patient care experience.   She shared a draft survey tool that DPH developed with the nursing home industry and  that surveyors could eventually incorporate into the state survey process. The tool has been tested in four long term care facilities to date and has been shared with CMS as a possible national model for survey reform. The form incorporates resident/patient interviews using the 3-Item care Transition Measure (CTM-3), which Biondolillo suggested has the endorsement of the National Quality Forum for use in evaluating transition quality.

In response to questions and comments from some of the home health executives at the meeting, Dr Biondolillo:

–          reflected on the possibility of introducing a determination of need (DON) process  in Massachusetts for home health saying the DON rules may be reopened for changes in the coming year.   The compelling argument for home care or hospice would, she said, be quality of care based, not economic.

–          indicated a willingness to assist the Home Care Alliance  in getting physicians and hospitals to understand the complex Face to Face rule

–          expressed from her own personal experience as a physician support for home health efforts to change  Medicare practice to allow Nurse Practitioners to sign plans of care

–          agreed with sentiments expressed by at least one home health executive that there may be more that can be done to educate physicians that different patients may benefit from different post acute paths (i.e, directly  with support home) rather than following a standard for all patients path through a rehab hospital and/or nursing home

Home Health and Hospice ODF

This month’s CMS Home Health, Hospice & DME Open Door Forum  is scheduled for Wednesday, October 3, 2012 at 2:00 p.m.

To participate by phone:   Dial: 1-800-837-1935 & Reference Conference ID: 76245818.

The agenda includes:

1. Open Enrollment Announcement

2. Home Health & Hospice Quality Update

3. Home Health Care CAHPS Update

4. OASIS Training Update; OASIS-C Online Training: Integumentary Status Domain Pressure Ulcers

Open Q&A

Return to www.thinkhomecare.org.

New Website Created on State Health Care Payment Law Implementation

The state has announced a new web page on Mass.gov that will serve as a clearinghouse for information as the state implements the new health care cost containment law signed by Governor Patrick in August.

The site will host important announcements about the new law as well as information on Grants & Demonstrations,Stakeholder Meetings andBoards, Commissions & Task Forces. 

Thanks to the advocacy efforts of the Home Care Alliance, the association has been given the authority to name members on the “Task Force Related to Behavioral, Substance Use Disorder, and Mental Health Treatment”  as Governor Deval Patrick, joined by Secretary Jay Gonzalez, Secretary JudyAnn Bigby, Rep. Steven Walsh, Rep. Ronald Mariano, Attorney General Martha Coakley, Speaker of the House Robert DeLeo, signs the health care cost containment bill in Nurses' Hall. well as the “Commission to Review Public Payer Reimbursement Rates.”

The website also announces meetings to inform stakeholders of progress and potential opportunities related to the new law so those interested are encouraged to check the site regularly and stay tuned to our blog for other important updates.

Return to www.thinkhomecare.org.

HCA Starts Congressional Letter on Home Care Moratorium

Thanks to the advocacy efforts of the Home Care Alliance and the cooperation of legislative home care champions, Congressmen Jim McGovern (D-MA) and Walter Jones (R-NC) are circulating a letter to be sent to federal Health and Human Services Secretary Kathleen Sebelius urging her agency to utilize the authority given in the Affordable Care Act to establish a temporary and targeted moratorium on new home health providers to control fraud and abuse in troubled areas.

Alliance staff drafted the letter, which is now a bipartisan effort that is seeking support from Congressional representatives from across the country. HCA has sent direct letters to Secretary Sebelius in the past and has supported drives by national associations towards getting a temporary and targeted moratorium established. The fact that the entire industry has been punished for the actions of a few agencies in a few areas of the US has driven the repeated attempts at lobbying HHS. This moratorium action certainly would not halt fraudulent and abusive practices, but it does help to contain the problem, especially in areas that have seen dramatic growth in the number of certified home health agencies.

The Alliance strongly encourages its members and supporters to contact their representative and urge them to sign on. Let your federal representative offices know that they should contact Congressman McGovern’s office to sign on.

Return to www.thinkhomecare.org.

Register for Great Events in October

October is a busy month for events at the Home Care Alliance with some unique opportunities to hear insight from state government on their activity around care transitions, hospice/palliative care initiatives, and electronic health record implementation. http://primagine.files.wordpress.com/2010/10/fall-leaves-1.png

The month kicks off with an Executive Breakfast with Madeleine Biondolillo, MD on October 4. Dr. Biondolillo  is the Director of the Mass DPH Bureau of Health Care Safety and Quality, which is responsible for such efforts as improving care transitions, implementing new End Of Life Care Initiatives, and establishing a health care workforce center.

The Alliance is also pleased to host a free event at the VNA of Boston on October 5th for home health IT personnel as well as other interested agency leaders and staff on the state’s “Last Mile” Implementation regarding electronic health records. This event will involve a presentation and discussion with Lawrence Stuntz who is the Director of the Massachusetts eHealth Institute, the Commonwealth’s entity for health care innovation, technology, and competitiveness. Although there is no cost, HCA is requiring registration.

To see our other events for this month, including informative webinars and meetings, check out HCA’s calendar of events.

Return to www.thinkhomecare.org.

 

The Alliance’s Colleen Bayard on the the Affordable Care Act

Colleen Bayard, the Alliance’s director of regulatory & clinical and regulatory affairs, spoke to WWLP News 22 this week about the impact of the Affordable Care Act on seniors in Massachusetts.

BOSTON (WWLP) – Government health officials say that President Obama’s national health care reform law is saving Massachusetts seniors big bucks.

Federal officials say the 2010 law has helped save Massachusetts seniors more than $76 million on medication bills this year.

The U.S. Department of Health and Human Servicessays in the first eight months of this year, the Affordable Care Act has saved seniors in Medicare’s “donut hole” about $610 dollars. Previously, when seniors were in this “donut hole” they would go from making copayments for their drugs to paying 100 percent of the cost.

The law gives them significant discounts.

“There’s actually extra funding for medications for seniors,” said Colleen Bayard, the Clinical Affairs Director for the Home Care Alliance of Massachusetts.

“They may not have enough money for their medications and it becomes unaffordable, but I think they’re trying to, they made changes with the medication in Medicare D to help with that.”

The average savings for a Massachusetts resident with Medicare will be $5,000. People with high prescriptions costs will save more than $18,000 from 2010 to 2022.

Don Berwick, MD heads 2013 Northeast Home Health Leadership Summit Line-Up

Its not too soon to make plans to be in Boston on Jan 22-24, 2013 for the  2013 Northeast Home Health Leadership Summit.  For your consideration:

  • Our theme this year is “The Magic of Leadership”.
  • We will be returning to The Colonnade Hotel, 120 Huntington Ave. Boston – across from the Prudential Tower.
  • Our keynote speaker is Don Berwick, MD, former Administrator of the Centers for Medicare and Medicaid Services
  • Other speakers include:  Dr. William Thomas on “Elderhood Rising: The Dawn of a New World Age and Sarah McKinnon on “From a Good Boss to a Great Leader.  Bates Communications will be presenting “Speak Like a CEO” (a personal consultation will be available on Day 2 for an additional fee); and we have some other “magical” presenters in the lineup.
  • The pre-conference session will focus on utilizing data as a management and marketing tool.
  • The Summit website at www.nehomehealthsummit.com has hotel information up now and registration information shortly.

Return to www.thinkhomecare.org.