Electronic Visit Verification (EVV) System Resource Page Now Available for HCA Members!

April 17, 2019

The Home Care Alliance of MA is happy to announce a resource page completely dedicated to keeping Home Health Care Providers informed for the upcoming Electronic Visit Verification (EVV) Mandate. You can access this page by going to www.thinkhomecare.org/EVV

Massachusetts Executive Office of Elder Affairs is moving forward with “deliberate speed” to implement the federal EVV mandate.  Massachusetts is developing a hybrid model for EVV, allowing agencies to use their current EVV vendor or choose any vendor that can collect and transmit the required data elements.  For those agencies without an EVV vendor, Massachusetts has contracted with Optum to design a free EVV system.  The current schedule would require personal care agencies that participate in the MA Home Care program that currently have an EVV system in place to begin testing in late 2018. Personal care agencies that don’t currently have an EVV system in place will have additional time to either go live with the Optum system or select and implement an EVV system from another vendor.

According to data collected by EOEA, well over half of the EOEA home care provider agencies in MA do not currently have an EVV vendor.  These agencies will have to make important purchasing decisions within the next year. This page is created to provide the must up to date information on EVV including important resources, vendor information and more.

EVV Vendor Webinar Series

Along with access to to important documents, websites, and contact information – HCA of MA has developed a monthly webinar series that allows EVV Vendors a one hour webinar to demonstrate their platform to our members for FREE! The webinars are typically held the 2nd Tuesday of every month and are recorded in the case you cannot listen to the series live.

The current schedule is as follows:

March 19th – Agency Workforce Management (Recording Available)

April 9th – HHAeXchange (Recording Available)

April 23rd – CellTrak

May 14th – Homecare GPS

June 11th – HomeCareIT

July 9th – Sandata

August 13th – 4Tellus

September 10th – ClearCare

REGISTER ONLINE

*Registering online gains you access to all webinars currently scheduled and any future webinars that may be scheduled

 

EVV Implementation: One Agency’s Experience

One additional resource webinar will be a one hour program with an agency member: HebrewSenior Life. Members of the HSL Leadership Team as they share their experience with implementing an EVV platform.  They will offer product highlights and the benefit and impact experience for clients, workforce, operations, and finances. They will also share their approach to the establishment of policies, procedures, and timelines for success with onboarding for caregivers and leaders.

This webinar will be held on Wednesday, April 24 at 1:00PM. This is also FREE to members!

REGISTER HERE

Access the EVV Resource page at: http://www.thinkhomecare.org/EVV


HCA and Northeastern University Partner on Nurse Symposium in June

March 21, 2019

These days, it seems like every week a new report is published sounding the alarm of a rapidly aging population across the United States and a shortage of workers prepared to care for this barreling silver tsunami. So much of the media coverage and research is focused on the paraprofessional workforce.

See for example, these reports/publications:

However, the Home Care Alliance member surveys indicate that the problem is broader than just a shortage of home health aides. The availability of a trained nursing workforce to meet a growing home-based health care delivery system is also emerging as an issue. Compounding challenges are impacting our ability as an industry to attract nursing students into home and community-based settings after nursing school.  That is why, on June 7th the Home Care Alliance of Massachusetts and Northeastern’s School of Nursing are hosting a symposium on the very topic of building a home care nursing workforce at Northeastern University from 9AM – 3PM.

The event, titled: Nursing Call to Action: Building a Nursing Workforce to Deliver Complex Care at Home, will bring together more than 25 nursing schools and 25 home health providers for a day-long session. The program will kick-start a dialogue brainstorming new approaches for preparing and exposing Massachusetts nursing students for an increasingly intensive health delivery system in the home.

This event will look past the issue of reimbursement rates or ever-changing reforms at CMS, and instead will focus on four key areas:

  1. Identifying knowledge and skills gaps for LPN/RN new-grads and what changes can be made to address the gaps and develop competencies in executing highly complex services
  2. Elevating the visibility to nursing schools of the growing demand for home-based services and the need to expose students to possible careers in home care nursing
  3. Identifying strategies on recruitment as new-grads and experienced nurses prepare for possible careers in home care nursing
  4. Identifying barriers and strategies to get home health agencies more involved in clinical placements for nursing students

If you would like more information on this event, please reach out to Jake Krilovich. Please note: There is limited space for this event!


PDGM Fix Introduced, Advocacy Needed

February 21, 2019

Last week, a bipartisan group of senators, led by Sen Susan Collins (R-ME)  introduced what will be a most important legislative priority for HCA of MA this year.  Senate bill (S.433) will curtail the so-called $1 billion “behavioral adjustment” cut under the Patient Driven Groupings Model (PDGM) to which all of home health is transitioning in 2020.  Among, many other changes, PDGM will move home health from a 60 to a 30 day payment unit. This is the most significant change to home health payment since the Prospective Payment System was introduced in 2000.

The Congressional action that called for a home health payment overhaul required that the new payment model be budget neutral against current spending levels. However,  the legislation also allowed that CMS to consider “behavioral  adjustments” defined as industry actions that would be taken to increase payment under the new model, unrelated to patient case mix changes. CMS has used this authority very broadly to institute a payment adjustment in the first year of PDGM based on “assumptions” of behavioral changes, and that adjustment calls for a 6.42% base rate reduction, or a possible $1b reduction in payments.

S 433 would prohibit CMS from making any pre-rate change reductions based on assumptions and instead to phase in any adjustments (either up or down) based on observed evidence (i.e., data supported) changes in provider behavior. The objective would be to achieve budget neutrality by 2029. This later piece addresses concerns the Congressional Budget Office (CBO) expressed regarding whether a similar bill introduced last session was truly budget neutral. S.433 also would allow Medicare advantage plans and Center for Medicare and Medicaid Innovations (CMMI) to waive the “confined to home”  provision when in the best interest of a Medicare beneficiary.

Regardless of the “behavioral adjustments,” the PDGM model is expected to have a tremendously varied impact state by state and agency by agency.  A significant amount of this impact is related to a Congressional  requirement that the payment model no longer use the volume of therapy as a payment level determinant.  (Something MEDPAC has been calling on CMS to do for years.)   The state of Florida, where therapy visits average 10.45 per episode of care is set to “lose” the most – projected at $141 million.  California on the other hand, where the average therapy utilization per episode was 5.76,  will be the largest gainer.  MA (need numbers from Tim)  Note: S 433 does not seek to make changes to the structure of the payment model that produces these changes.

It is important to reflect on CMS’ proposal in 2017, Home Health Groupings Model (HHGM) and how we arrived to where we are today. At the time, HHGM represented similar changes to the payment model, without soliciting industry feedback and some estimates predicting a 15% reduction in payments. As a result, the industry unified itself behind one message: that CMS withdraw its proposal and engage stakeholders to come up with an alternative. Upwards of 13,000 emails were sent to Congress from the industry, 49 members of the U.S. Senate and almost 160 members of the U.S. House of Representatives signed onto letters to CMS echoing the request to withdraw HHGM. This was a remarkable show of mobilization by the industry and we’ll need it again to make modifications to PDGM.

At present there is no bill in the House, but it is expected that one will be forthcoming.  Strong early sign on support is critical to keeping this bill moving and HCA of MA will be urging members to contact the MA delegation to support S.433 and the companion house legislation to be introduced. Stay tuned for these advocacy alerts in our weekly newsletter and advocacy messages in the coming weeks.

HCA will also be hosting a number of member events to prepare for the payment transition.  While the full day PDGM programs in March in Northampton are sold out, there will be a high concentration of sessions on PDGM at the New England Home Care Conference and Trade Show in on June 5 -7 inn Falmouth. Watch here for more details.

In the meantime, send a message here to Senators Warren and Markey about the need for their support on this issue. 

Let’s do this home care – we cannot sustain $1 billion in cuts based on assumptions, not facts!


Education Doesn’t Stop for Winter: It’s Webinar Season!

January 9, 2019

The Home Care Alliance of MA is proud to top education to our members on important and relevant topics. There are roughly 5-8 programs held a month and during the winter, they mostly belong to webinar education! Webinars are a cost effective way of educating your staff – you pay an affordable price for one line and have staff gather in a room to listen together, or access the recording for a later date training.

Below you will find some of our current webinars being offered which range in topics from Coding to CASPER reports to Aide education.

There are continuously new programs offered including on-site education, trainings, and conferences. Check out our calendar on our website to stay the most informed!

Contact Megan Fournier at mfournier@thinkhomecare.org or 617-482-8830 for any questions!


HCA Submits Comment on Medicare Changes; Submit Your Comments Now!

August 30, 2018

On July 1st, 2018, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule which includes several changes to the home health benefit for 2019 and beyond. The public comment period closes this Friday August 31, 2018, at 11:59 p.m. As of this blog posting, 760 comments have been submitted to CMS which is encouraging, but far from the more than 1,300 comments submitted last year in response to the HHGM proposal which was ultimately withdrawn.

You can view the HCA’s written comments here and can download the word document here.

You may submit your own comments to CMS here.

Here are some of the key changes proposed, and an overview of HCA’s response:

Home Health Wage Index Changes

  • The 2019 proposed payment rates increase by 2.1% which represents a $400 million increase.
  • HCA of MA has long expressed concerns to CMS over inequities in how the wage index is calculated for home health agencies compared to hospitals. HCA urges CMS to adjust the 2019 home health agency wage index to reflect a policy to limit the wage index disparity between provider types within a given CBSA.

Proposed Patient Driven Groupings Model (PDGM) for CY 2020

  • Implementation: As the proposed PDGM would mark a major change in the way home health agencies will be reimbursed, the HCA urges CMS to delay implementation by one year to ensure that there is no disruption in access to services for beneficiaries and evaluate the accuracy of the model and its effect.

  • LUPA Thresholds: CMS proposes to set the LUPA visit threshold at the 10th percentile for each payment group. HCA believes this is complex and will complicate the care planning process for home health agencies. HCA urges CMS to retain the current LUPA thresholds and revisit them in future years.

  • Behavioral Assumptions: CMS proposed three ‘behavioral assumptions’ in the PDGM totaling -6.42%. However, these assumptions are not based in data or evidence. HCA believes that two of the three assumptions already exist in the current PPS methodology including; that agencies are already incentivized to both report the highest playing diagnosis codes and to develop and deliver plans of care that exceed the LUPA threshold. This could result in an over estimated impact of behavioral assumptions and the HCA urges CMS to eliminate the Clinical Group Coding and LUPA threshold assumptions.

  • Split percentage payment approach: HCA believes that changing from a 60 to 30 day billing period will be very disruptive to agencies’ operations and increase back-office costs. Therefore, HCA urges CMS to continue the split payment approach at the current 60/40 and 50/50 splits for early and late periods, respectively, to give agencies cash flow breathing room.

  • Certification and Re-certification of Patient Eligibility: HCA has long advocated for regulatory language to align with sub-regulatory guidance as it relates to documentation of the patient’s eligibility. HCA is encouraged by CMS’ proposal to eliminate the requirement that the physician provide an estimate of how much longer skilled services are required and we request that CMS consider revisions to the physician’s burden of the F2F encounter as a condition of payment. 
  • Remote Patient Monitoring: HCA strongly supports the proposal to recognize remote patient monitoring costs as an administrative cost on the HHA cost report. HCA does recommend however that CMS remove the regulation that does not allow remote patient monitoring to be used as a substitute for in-person home health services. 
  • Home Health Value Based Purchasing Model: HCA has long supported the HHVBP model aiming to improve quality by giving HHAs incentives to provide better quality care. However, HCA urges CMS to modify the HHVBP to recognize stabilization in the scoring because in many cases, stabilization (instead of improvement) is an appropriate goal for some patients.

Talking Home Care: Ryan McEniff on Running a Private Care Agency

August 6, 2018
Ryan McEniff of Minute Women

Ryan McEniff

How did a “big, six-foot-six, burly guy” become the owner of Minute Women Home Care? For the seventh episode of the Talking Home Care podcast, Pat Kelleher talks with Ryan McEniff about what it takes to run a successful private home care agency. Topics include:

  • Ryan’s personal story about entering the industry;
  • The challenges (and opportunities) of transitioning from family to paid home care;
  • How home care can restore clients’ work/life balance;
  • Whether home care can remain affordable to middle-class families in a bustling economy;
  • Why finding (and keeping) the best staff is sometimes a bigger challenge than attracting clients;
  • Going the extra mile to protect clients with national background checks;
  • The single most important question all families should ask when choosing an agency for their loved ones (jump ahead to 34’35” to find out); and
  • Ryan’s own podcast, The Caregiver’s Toolbox (expect Pat on an upcoming episode).


You may listen to the podcast by clicking the play button above, downloading it directly, or subscribing through iTunes or Google Play. (Length: 37 minutes; Size: 18 MB). If you enjoyed it, please give us a five-star review so others can find it as well.

Host: Patricia Kelleher is the Executive Director of the Home Care Alliance of Massachusetts.

GuestRyan McEniff has been the owner of Minute Women Home Care since 2013. He became passionate about home care when his mother needed care while battling cancer. He is also a Certified Dementia Practitioner and the host of The Caregiver’s Toolbox podcast.


Talking Home Care LogoDon’t want to miss the next episode of Talking Home Care? Subscribe through iTunes, Google Play, or accessing its feed directly.

Return to www.thinkhomecare.org.


Talking Home Care: Eric Scharber on Workforce Challenges: “Whoever Has the Talent Is Going to Win”

May 22, 2018
Eric Scharber of Exact Recruiting

Eric Scharber

For the sixth episode of the Talking Home Care podcast, Pat Kelleher talks recruiting and retention with Eric Scharber, a principal of Exact Recruiting. Topics include:

  • The advantages to employers of focusing on retention as much as recruiting
  • How small changes in retention can make a real difference to an agency’s bottom line
  • Why offering staff development is sometimes more important than pay increases
  • The challenges (and opportunities) of hiring Millennials
  • How to get graduating nurses and therapists to consider careers in home care and hospice
  • The specific challenges of retaining non-medical caregivers such as CNAs and home health aides

You may listen to the podcast by clicking the play button above, downloading it directly, or subscribing through iTunes or Google Play. (Length: 28’30”; Size: 15 MB).

Host: Patricia Kelleher is the Executive Director of the Home Care Alliance of Massachusetts.

GuestEric Scharber is a principal at Exact Recruiting, a Simione Talent Solution, where he leads talent acquisition and employee retention for the home care and hospice industry. He oversees executive search and non-executive recruiting services, as well as recruitment process outsourcing, compensation analysis, and employee satisfaction survey services.

Talking Home Care LogoDon’t want to miss the next episode of Talking Home Care? Subscribe through iTunes, Google Play, or enter the following in your podcast app: https://thinkhomecare.wordpress.com/category/talking-home-care-podcast/feed/

Return to www.thinkhomecare.org.


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