Panel Review Dates Announced for Care Transitions Program

The Centers for Medicare and Medicaid Services announced panel review deadlines for applications to be submitted for the Affordable Care Act’s Section 3026 Community-Based Care Transitions Program.

  • July 19, 2011 – Applications must be received no later than June 20, 2011 to be considered for this review.
  • August 24, 2011 – Applications must be received no later than July 15, 2011 to be considered for this review.
  • September 19, 2011 – Applications must be received no later than August 18, 2011 to be considered for this review.

The Home Care Alliance has received questions regarding the assembly of a budget for the application and a helpful guide  is available upon request for those interested.

Guidance is also still available on the Q&A section of the CMS Care Transition Program’s web page.

Return to www.thinkhomecare.org.

 

CMS Home Health Quality Campaign will Continue, NAHC Announces

The National Association for Home Care & Hospice (NAHC) has announced that the CMS Home Health Quality Improvement Campaign (HHQI) will continue after July 31, 2011.

The goal of the HHQI Campaign is to improve the quality of care home health patients receive as measured by a reduction of avoidable hospitalizations and improvement in the management of oral medications. Throughout the campaign, a variety of materials as well as online communication and sharing tools have been and will continue to be available to Campaign participants. These include Best Practice Intervention Packages (BPIPs), which will be released quarterly to share effective strategies with home health care providers.

Campaign participants will also be able to set improvement targets and view rates related to the publicly reported acute care hospitalization and oral medication measures through a free target-setting tool at the Home Health STAR (Setting Targets Achieving Results) Web site.

According to NAHC, the  second phase of the campaign was set to conclude at the end of July, but CMS has indicated that the HHQI movement will proceed into a third phase. As a result home health agencies will be able to continue to access free quality improvement resources at www.homehealthquality.org.

Before the next phase starts later this year (the details on what the third phase will entail has yet to be announced) home care agencies are asked to fill out a simple form and share input on how the campaign can improve. The HHQI National Campaign has created a brief three-question assessment that asks for insights, along with name, e-mail address and phone number. It can be filled out at: http://www.homehealthquality.org/hh/about/feedback/default.aspx.

The Home Care Alliance is a Local Area Network of Excellence (LANE), which means that the association is responsible for agency recruitment in Massachusetts and the dissemination of information and materials from the national campaign. For more information on the campaign, please visit www.homehealthquality.org/.

Return to www.thinkhomecare.org.

OIG Issues Advisory Opinion on E-Discharge Systems

The Office of the Inspector General issued an advisory opinion on May 13 (publicly posted on May 20th) stating that being charged a fee to electronically receive and respond to referral requests from hospitals for post discharge care violates the federal anti-kickback statute.

The full document relating to what are known as “e-discharge” systems includes background information, legal analysis, and potential sanctions from OIG is available here.

Return to www.thinkhomecare.org.

Payment Rate Change Announced for Hospice

The state’s Division of Health Care Finance and Policy (DHCFP) announced an adjustment in the rate of payment for hospice services “in accordance with CMS requirements.”

The full announcement is available here.

The change is estimated by DHCFP to increase the MassHealth budget by $184,274 or 2.68%, which translates to a slight increase and not a cut as is sometimes meant when the state uses the word “adjustment.” According to the announcment, each rate is composed of a non-wage component and a wage component, in which the latter is adjusted by a county-specific, Massachusetts wage index, in accordance with CMS guidelines.

Depending on the service, the rates in these county-groupings change within the following ranges:

  • 3.5-3.7% for Norfolk, Suffolk, and Plymouth,
  • 3.0-3.2% for Middlesex,
  • 2.6-2.7% for Essex,
  • 2.4-2.5% for Bristol, 3.2-3.4% for Berkshire and Pittsfield,
  • 1.7-1.9% for Hampden, Hampshire, and Franklin,
  • 3.4-3.6% for Worcester,
  • 1.6-1.9% for Barnstable
  • 1.9-2.2% for Nantucket and Dukes.

Although the revisions were adopted by emergency regulation on May 27, they are still technically “proposed” and are subject to further change. DHCFP announced that there will be a hearing on July 7 in Boston for anyone interested in offering comments on the matter. See the full announcement for details.


Return to www.thinkhomecare.org.

Impact of Face-to-Face in a Health Care Reform World

Home Care Alliance of MA and RBC Limited have joined together to offer this valuable webcast.

While enforcement of the Face-to-Face (F2F) Encounter was delayed until April 1, 2011, many agencies are just now realizing the potential adverse impact of this new regulation.  How have your peers modified processes and practices to ensure success with this new requirement?  What practices and tools have emerged that support success with the new Face-to-Face Encounter requirement?

You don’t want to miss out on this program.

It is critical that your staff understand the far reaching impact of this new F2F regulation and how to integrate NEW practices to protect agency reimbursement, ensure COMPLIANCE and successful outcomes.

Program Objectives:
Upon completion of this program participants will be able to:

  • Provide a critical review of the F2F Encounter requirement;
  • Detail the impact of this requirement on current agency outcomes and processes;
  • Identify emerging industry Best Practices that meet the challenges of the F2F Encounter;
  • Discuss agency strategies to support ongoing success with this new regulation.

Take Away Tools:  

  • Sample Physician Guide with Face-to-Face Document
  • Sample Staff Education Guide

Audience: This session is geared toward leadership and staff who are involved in the education and planning to enhance clinical care and services.  Directors, supervisors, compliance and risk management staff, educators and quality management staff as well as clinicians are encouraged to participate in this program.

About the Speaker:  Patricia W. Tulloch RN, BSN, MSN, HCS-D, is a seasoned clinician with more than thirty years in the healthcare industry, including twelve years in home health and hospice clinical management and more than thirteen years as a Senior Consultant with RBC Limited, a Healthcare & Management Consulting Firm.

REGISTRATION INFORMATION:  

WEBCAST ORDERS – Price: $99.00
ONE YEAR UNLIMITED 24/7 online staff access – at your convenience. You pick the time that works for your schedule to watch.

DVD ORDERS – Price: $99.00 + $5 shipping fee
Please allow 5 to 7 business days to process your order once the program becomes available. Every effort will be made to process your order as soon as possible.

TO REGISTER, CLICK ON THE LINK BELOW AND GO TO ITEM 141:

(When registering, be sure to enter State Code: MA02116 on the Review Your Cart page.)

http://education.rbclimited.com/store

Questions about the program or registration, contact RBC at 845.889.8128 or rbc@netstep.net.

RBC Limited Healthcare & Management Consultants
T: 845.889.8128 / F: 845.889.4147 / E: rbc@netstep.net / Website: www.rbclimited.com

Advocacy Alert: Send an Email to Budget Conferees to Support Telehealth

A new advocacy message is available to click and send to legislators who are part of the FY 2012 Budget Conference Committee, which is charged with compromising the House and Senate versions of the state budget before it’s sent to the Governor.

The Home Care Alliance, thanks to State Senator Richard Moore, saw a Senate budget amendment pass that would bring MassHealth reimbursement for telehealth services provided by a home health agency.

You can help support this issue by visiting the HCA’s Legislative Action Center and clicking on the telehealth message. Simply fill out your contact information and click “send messages” to email each member of the conference committee.

Here is the language of the telehealth budget amendment (# 593) that passed in the Senate:

Messrs. Moore, Montigny and Tarr moved that the bill be amended, in Section 2, in item 4000-0500, by adding the following words:- “; provided further, that for purposes of long-term health care cost savings and enhanced patient care, the commonwealth shall recognize telehealth remote patient monitoring provided by home health agencies as a service to clients otherwise reimbursable through Medicaid”.

You can also call the conference committee members and ask that they support Senate budget amendment # 593 relative to telehealth. Contact info for the conferees is below:

  • Sen. Stephen Brewer – 617-722-1540
  • Sen. Steven Baddour – 617-722-1604
  • Sen. Michael Knapik – 617-722-1415
  • Rep. Brian Dempsey – 617-722-2990
  • Rep. Viriato Manuel deMacedo – 617-722-2100
  • Rep. Stephen Kulik – 617-722-2380

If you have any questions or would like to learn more, please contact the Alliance.

Return to www.thinkhomecare.org.

Home Care Again Named Among Fastest Growing Jobs

The US Bureau of Labor Statistics again named home health aides and home care aides as two of the top three fastest growing jobs over the coming years.

The Boston Globe featured these jobs as a special section on their website. Of course, many healthcare occupations and especially those in the community, will see large increases to support the expected massive growth in the elderly population.

To search for jobs in home care in Massachusetts, visit our job bank.

Return to www.thinkhomecare.org.

State Senate Budget Includes Telehealth

The state senate this week passed a $30.5 billion state budget for FY 2012 that included a major priority of the Home Care Alliance.

An amendment instructing MassHealth to reimburse for telehealth remote patient monitoring provided by a home health agency was adopted by the Senate.  That provision must now survive a conference committee made up of House and Senate members who will work out differences between the House and Senate budget proposals and send the finished version to the Governor for his approval.

The amendment passage is a victory for home health care and reflects a greater understanding from the state legislature on issues important to the industry. Moreover, the adoption of the telehealth amendment, while only a first step in the process, is also recognition of the cost savings that home health agencies and the use of technology can provide.

Most of the 599 budget amendments proposed in the Senate did not make it through, including restoration of MassHealth rates of payment for home health past 60 days, a pediatric home care amendment, and another that would have established a special care transitions rate for home care agencies.

Two amendments regarding adult day health were also adopted.  One would establish licensure standards for adult day health providers and the other would require MassHealth to notify the legislature of any changes to rates or clinical eligibility criteria for adult day health services.

Other amendments of note include:

  • An amendment was adopted that would require MassHealth to annually notify each beneficiary over 65 about their options regarding enrollment in voluntary programs, including Program of All Inclusive Care for the Elderly (PACE) plans, MassHealth Senior Care Options, Frail Elder Home and Community Based Waiver Program and “any other voluntary elected benefit to which such beneficiary is entitled to supplement or replace such beneficiary’s MassHealth benefits.”
  • An amendment was rejected that would allow nursing homes to place a hold on beds for residents who are transferred to the hospital for emergency care.
  • An amendment was adopted to provide an additional $1 million for elder protective services (total amount: $16,250,554).
  • An amendment was adopted to provide an undisclosed amount of funding to elder pre-admission options counseling.
  • An amendment was adopted providing an additional $4 million for Day Habilitation Services
  • The Salary Reserve for human service workers was not approved, but the Senate did approve a substitute amendment enable human service provider agencies to purchase health insurance through the Commonwealth Health Insurance Connector for their employees earning less than $40,000/year.

For any questions or further information on the state budget, contact James Fuccione at the Alliance.

Return to www.thinkhomecare.org.

Advocacy Messages Now Available for Senate Budget

The Home Care Alliance has several important amendments filed in the FY 2012 Senate budget and messages to support these initiatives are available here.

Here are the issues HCA is advocating for:

Amendment #483 – Home Health Care Rates, filed by Senator Michael Moore.

  • The MassHealth home health payment rate was cut by 20 percent to patients receiving skilled nursing care past 60 days of care in December of 2008. This created a new payment category that goes from $86.99 to $69.59 for patients that require longer periods of care and who are at a greater risk of inpatient facility admissions or readmissions.
  • Since all of MassHealth’s home health services receive a 50 percent federal match, the actual state expenditures reflect only half of a $7.1 million budget increase.

Amendment #478 – MassHealth Home Care, filed by Senator Steven Tolman.

  • This amendment establishes a special MassHealth rate to reward home health agencies that are successful in helping patients discharged from acute care avoid a costly re-hospitalization for the same condition for which they were originally hospitalized.
  • The hospitalization would have to be avoided for at least 30 days in order for the payment to be administered. The Secretary of Health and Human Services shall determine the rate, which will be based on a nurse-led team model.
  • This provision would increase the efficiency of care and save costs for the state in avoiding rehospitalizations.

Amendment #481 – Pediatric Home Care Services, filed by Senator Michael Moore.

  • This amendment does not increase any rate, but merely shifts existing payment recognizing a home health agency’s administrative requirements. Also, this amendment ensures safety and quality by allowing only registered nurses to care for multiple patients in a single setting.

Amendment #593 –  Telehealth Reimbursement, filed by Senator Richard Moore.

  • In recent years, several states have all moved forward with incorporating coverage of telehealth into their state plan, waiver home care programs, or have authorized funding for demonstration projects to support telemonitoring equipment purchases.
  • The Centers for Medicare and Medicaid Services also recognize and define telehealth billing and reimbursement practices.
  • Telehealth and remote care management programs are not only proven to reduce admissions to hospitals and nursing homes, but also reduce the frequency of home health visits.
  • Such lower cost services increase communication with physicians and caregivers, which contributes to the enhancement of care. It also increases patient self-management and is widely regarding as a cost savings measure supported by a number of studies and pilot programs.

Amendment # 589 – Adult Day Health Services, filed by Senator Richard Moore.

  • A $55 million cut to Adult Day Health (ADH) services was proposed in the Governor’s budget and this amendment would freeze the current level of reimbursement to prevent that reduction from occurring. The amendment would also impose a moratorium on new ADH facilities until a study on ADH rates and services is completed by the Executive Offices of Health and Human Services and Elder Affairs.

Amendment #586 – MassHealth/Medicare Dual Eligible Demonstration Project, filed by Senator Thomas Kennedy.

  • The Patrick administration is exploring a demonstration program that would offer a new integrated care product to MassHealth members that are dually-eligible for Medicare.  The new program would apply to individuals who are eligible for both Medicare and Medicaid, and who are between 21 and 65 years old.
  • The proposal envisions the MassHealth program receiving Medicare funds from the federal government for the purpose of managing the care of dual eligible patients.  MassHealth would then pay “Integrated Care Entities” a global payment for the care of a group of enrollees.
  • The governor’s FY2012 state budget recommendation assumes $50 million in savings from the proposed initiative. MassHealth states these savings will be achieved by better coordination and management of the dually eligible population.  While the $50 million savings estimate is not based on provider rate reductions, legislative guidelines for this dually-eligible demonstration effort are needed to assure hospital, physician, and home health care payments continue at current Medicare levels.

Return to www.thinkhomecare.org.

Hearing Kicks-off Public Comment Period on Payment Reform

A packed hearing in the State House’s Gardner Auditorium on Monday kick-started the conversation on what is likely to be the biggest change in the Massachusetts health care delivery system since the state passed universal coverage in 2006.

The Governor’s payment reform legislation would move the system of paying for all health care in the state from a fee-for-service model to more of a global payment model, with accountable care organizations responsible for delivering quality care in a manner that slows the growth of spending.

Much of the testimony and discussion is centering on how prescriptive the legislation will be in terms of mandatory versus voluntary participation, and the composition and authority of various oversight boards and advisory committees. Rey Spadoni, President & CEO of the Visiting Nurse Association of Boston and James Fuccione of the Home Care Alliance presented testimony regarding the need to recognize the importance of including the full continuum of care in any ACO model and central role that home care can play in a system that becomes more patient-centered, more cost conscious and accountable.

The Alliance, in particular, has asked in its testimony that the legislation be amended to require at least one home health/post-acute provider to be included on every ACO’s governing body.  The VNAB testimony asked that the new model recognize home health’s “investments in technology, clinical centers of excellence that serve patients with chronic disease, staff training and the addition of support services designed to keep people at home and independent or achieving the highest quality of life levels possible for them.”

The Home Care Alliance strongly encourages every interested agency to submit written testimony, which can be sent to the Alliance to collect and forward on to the Joint Committee on Health Care Financing, or to show up at public hearings being held across the state at the dates below:

  • Monday, May 23 at 11:00 a.m. at UMASS Medical School, Worcester (55 Lake Avenue North, 6th Floor of the medical school, Amphitheatre 3)
  • Monday, June 6 at 11:00 a.m. at Salem State University, Salem (71B Loring Avenue, Central Campus, Marsh 210)

The Alliance needs members to offering verbal or written comments if we are to be successful in carving an explicit role for home care into the ACO model.

The Home Care Alliance previously released a position paper on ACO’s prior to the Governor’s legislation that can be used to guide comments.

Return to www.thinkhomecare.org.