Caring Magazine Highlights Massachusetts Care Transitions Programs

The great work being done by home care agencies in Massachusetts around care transitions was highlighted in an article in the current issue of Caring Magazine, the monthly publication of the National Association for Home Care & Hospice (NAHC).

In the article written by the Home Care Alliance, the focus is on four agencies involved in the STAAR project (State Action on Avoidable Readmissions) and how their collaborative programs have changed how care transitions are handled.

Additionally, the Home Care Alliance’s “Opt-In” document, a guide to Optimum Performance Standards for Transitions to and From Home Health, is highlighted and shown as a beacon for the work performed by these four agencies and any other agencies or  providers working with home health to improve care transitions.

Return to www.thinkhomecare.org.

 

 

 

It’s All About Innovation

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.

CMS Posts Final Rule for 2012 PPS Rates

CMS this week posted the final rule for Medicare home health PPS rates for calendar year 2012.  The finalized rates are slightly better than the proposed rates that CMS released in July, due to the fact that CMS has accepted industry recommendations to phase-in the case mix creep adjustment over two years, applying a 3.79% adjustment in 2012 and reserving 1.32% for 2013. Still, the 2012 national standard episodic rate of $2138.52 is a reduction from the 2011 rate of $2192.07.

The final 2012 rate is represents a 2.4% reduction from the 2011 rate, the result of a combined 2.4% market basket index inflation update, a 1% reduction in the inflation update required by the health care reform law, and a 3.79% case mix creep adjustment.
The final rule also adjusts the case mix weight for every HHRG to adjust for budget neutrality after removing eliminating hypertension as a factor in the calculation.  The rule also reduces the weights on high-therapy episodes and increasing weights on non-therapy episodes.

See this spreadsheet listing the updated rates for all HHRG’s in each MA geographic region.

In addition to setting forth updates to PPS, the final rule included some minor changes regarding face-to-face (F2F) encounters.  CMS is removing the modifier “attending” from the regulatory language to describe physicians who qualify as the physician who cared for the patient in an acute or post-acute facility. Most people considered the word ‘attending” to mean a community physician and not the in-patient physician.

Acknowledging that the Affordable Care Act did not preclude a patients’ acute or post-acute care physician from informing the certifying physician (physician who signs the 485) regarding their experience with the patient for the purpose of the F2F encounter requirement as an NPP can, CMS is also amending the F2F language to allow the acute or post-acute care physician to inform the certifying physician regarding the F2F.  The “community physician” could then complete the necessary documentation.

CMS believes these modifications allow additional flexibility in the process, making it easier for providers. Members with questions about the F2F changes can contact Helen Siegel at the Alliance office.

This finalized regulation will be the subject of an in-depth review by representatives of Blacktree Healthcare Consulting during the Alliance’s 2011 Financial Management Conference November 30 in Waltham.  Be sure to register today!

Return to www.thinkhomecare.org.

DHCFP Proposes New ASAP Rates, Hearing Scheduled

Implementing another provision of the Purchase of Service reform, the MA Division of Health Care Finance & Policy is assuming rate setting authority over ASAP rates effective January 1, 2012.  This week, DHCFP published the proposed rates for calendar year 2012, along with a notice of a public hearing to be held on Wednesday, December 14, 2011 at 10:00 AM at the DHCFP, Two Boylston Street, 5th floor, Boston.

DHCFP is proposing a new section of its regulations at 114.4 CMR 17.00: Rates for Certain Elder Care Services.  The proposed regulation establishes payment rates for Home Care and Enhanced Community Options Program (ECOP) services purchased by the Executive Office of Elder Affairs. The regulation establishes a bundled monthly payment to ASAPs for each client.  The proposed rate for the Home Care/Respite Care program is $266.52 per client per month.  This rate does not include any increase from the current rate. The proposed rate for ECOP is $662.12 per client per month, an increase of just $2.92 from the current contract rate.

Note that the DHCFP regulation does not set contractor agency rates.  Those will continue to be set through the Homemaker NOI process managed by EOEA.

The Alliance will be testifying at the public hearing.  Any agencies interested in providing testimony – either in person or in writing – are encouraged to contact James Fuccione at the Alliance office.

Return to www.thinkhomecare.org.

Celebrate and Raise Awareness: November is National Home Care and Hospice Month

Every year, the home care and hospice community celebrates and raises awareness of the services that help keep people independent and at home for National Home Care & Hospice Month and National Family Caregivers Month in November.

With the Joint Select Committee on Deficit Reduction debating proposals to reduce the nation’s debt by trillions of dollars, the advocacy focus for this year must focus on opposing suggestions to impose copayments on Medicare home health services. A message also has to be sent that home care paid it’s fair share, $39.7 billion over ten years to be exact, for implementing the Affordable Care Act as well as how the industry has been thrown years of regulatory reductions.

Home care and hospice are cost-effective methods that care for people in the setting where they are most comfortable and familiar. Please help the Home Care Alliance raise awareness of these important issues and services, but also celebrate the great work performed by aides, clinicians, managers and all staff that make those services possible.

Here are some ways to celebrate and raise awareness for National Home Care & Hospice Month:

For Providers –

Press Release: Tailor this press release on National Home Care and Hospice Month to include information about your agency and the services you provide. Then, distribute to your local newspaper and/or local senior newsletter (Please contact the Alliance if you would like assistance or have any questions). There is also a separate press release template for hospices.

Op-Ed/Letter to the Editor: Select from the Opinion-Editorial drafts below depending on your interest (HCA would be happy to work with agencies on more specific or localized op-eds or letters to the editor).

For Everyone –

Facebook: Go to the Home Care Alliance’s Facebook page and click “like” on the most recent status regarding Home Care Month.

Twitter: add the hash-tag #homecaremonth to your tweets this month and especially if you’re helping celebrate and raise awareness.

Posters: Download and print the posters below. Post in your home or office, or send to friends and colleagues.

Advocacy: Send an email advocacy message to legislators from HCA’s Legislative Action Center.

Resources for Caregivers:

-Order the Home Care Alliance’s new 2012 Guide to Private Home Care Services and see HCA’s other helpful publications.

–Alzheimer’s Disease caregiver tip sheet from the National Family Caregivers Association.

–Guide to Advance Care Planning from the National Hospice & Palliative Care Organization.

-Information on the Home Care Alliance’s Home Care Accreditation Program.

-Read President Obama’s Proclamation to honor National Family Caregiver’s Month.

Return to www.thinkhomecare.org.

A Challenge to Home Care

Interesting and at least a bit encouraging, the CMS Director Don Berwick references home health as an essential part of a coordinated, seamless, patient centered care team in his October 20th, editorial in the New England Journal of Medicine (“Making  Good on ACO’s Promise). But, Dr Berwick leaves home health out of the definition of what will be required of applying entities to become Medicare’s first ACOs.  Dr Berwick presents  a vision in which Medicare beneficiaries “should find their care experience enhanced by a program that supports providers in engaging with their patients to deliver on the three-part aim: better care for individuals, better health for populations, and lower cost growth through improvements in care.”

Clearly Dr Berwick’s  vision is one that we all of share.  “Coordinated care,” he writes, ” is meant to allow providers to break away from the tyranny of the 15-minute visit, instill a renewed sense of collegiality, and return to the type of medicine that patients and families want.”  In this brave new world of coordination and collegiality, it will still be up to home care  to “sell” these organizing entities that home care has long understood and practiced patient centeredness, and that we have experience to spare and to share.

The Alliance is committed to helping us rise to Dr Berwick’s challlenge.

Find a full copy of the rule, here.


CLASS Act – Over Before it’s Begun

Once again, the needs of an aging nation in terms of support for long term care have been pushed aside with HHS Secretary Kathleen Sibelius’ announcement that the Obama Administration will not proceed with plans to implement a federally coordinated, voluntary national long term care insurance plan – known as the CLASS act

According to today’s Wall Street Journal, HHS officials gave up after “actuaries spent 19 months attempting to design a voluntary long-term care insurance program that met the requirements of the law.”  That called for making sure the program would remain fiscally solvent and pay for itself for at least 75 years.

Although the Class Act provision is little linked to the Affordable Care Act provision around providing basic health insurance universally, its  demise has inched open further the door to those who seeking to dismantle all of ACA piece by piece.   Senate Minority Leader Mitch McConnell (R., Ky.) said. “It is worth remembering that the Class Act is only one of the unwise, unsustainable components of an unwise, unsustainable law.”

Just what is unwise and unsustainable in your opinion: providing basic coverage and seeking a collective and shared solution to an aging society?   Or doing nothing?

Reports: CLASS Act Program is Being Removed from Health Care Reform

News outlets across the country are reporting on the elimination of the CLASS Act (Community Living Assistance Services and Supports), which would have provided a modest long-term care insurance benefit to help elders access community care services and remain in their homes.

This provision would have been a boost to home health, but research and reports by Health and Human Services found that there was no way to ensure that the program would be sustainable and the official announcement to repeal the program came late Friday afternoon.

The move itself, aside from political posturing, does not change the fact that there is “an enormous need” for long term care insurance as HHS Secretary Kathleen Sebelius put it. The New York Times quoted Secretary Sebelius as adding “At $75,000 a year for a nursing home and $18,000 a year for home health care, most families cannot afford to pay out of pocket.”

Return to www.thinkhomecare.org.

“At $75,000 a year for a nursing home and $18,000 a year for home health care, most families cannot afford to pay out of pocket,” she said.

Home Care Alliance Promoting DEA Drug Take-Back Program

Unused Drug DisposalThe Home Care Alliance and participating member agencies are encouraging home health patients and their families to participate in the federal Drug Enforcement Administration’s National Prescription Drug Take Back Day on Saturday, October 29, 2011, from 10:00 am – 2:00 pm.

Across the state and the nation, collection stations will be available at police stations, fire stations, senior centers and other facilities so that people can turn in unused and unwanted medications so that they can be disposed of safely. This year’s event marks the third annual Prescription Drug Take Back Day, where the first two programs combined to collect 309 tons of prescription drugs that were turned in, according to the DEA.

The Alliance has a press release template for member home health agencies interested in participating in this program and can contact James Fuccione at HCA for details.

Return to www.thinkhomecare.org.

Home Care Innovations, Star Award Nominations Open

This December, the Home Care Alliance of Massachusetts will present a unique event to showcase home care innovators and honor the best and brightest in the industry.  This day-long celebration of  innovation and excellence will take place Wednesday, December, 7, at the John F. Kennedy Presidential Library in Boston.

The Home Care Innovations Showcase will highlight programs, services or policies that represent the best in innovative thinking at our member agencies. The winning entries will be invited to make a brief presentation at the Dec. 7 event, with a focus on the innovation’s positive impact on their clients, their community, their agency or the delivery system at large.  Alliance member agencies are invited to nominate an innovation that has enhanced the health and well-being of their patients and clients, the efficiency of their operations, the health of their community or the well-being of staff.

The 2011 Home Care Star awards will be presented during a special luncheon program at the Dec. 7 event. The Star Awards celebrate the exceptional accomplishments of the everyday heroes who make such an incredible difference in the lives of their patients and clients.

Nomination materials for both the Home Care Innovations Showcase and the Home Care Star Awards are available on the Home Care Alliance website.  Nominations are due by October 17, 2011.