In The News

Congress Mulls Long-Term Care Reform

Modern Healthcare/Jessie Hellmann

The crisis facing long-term care is getting the attention of the president and members of Congress, raising hopes among stakeholders that reform might be on the way.
Demand for long-term care has increased in recent years as the aging population grows, and a wave of baby boomers retire in coming decades.
But as of now, the long-term care system is failing to meet the needs of the current population. It's fragmented, expensive and often inaccessible for low-and-middle income aging adults and people with disabilities. While most people are cared for at home by unpaid caregivers, lawmakers have looked to expand access to home and community services covered by Medicaid, the largest payer of long-term care in the U.S. ...

Legislation being worked on by Rep. Dingell, Sens. Bob Casey (D-Pa.), Maggie Hassan (D-N.H.) and Sherrod Brown (D-Ohio) would make coverage of HCBS mandatory under Medicaid, in an effort to eliminate the institutional bias that experts say the current structure supports.
Under a draft version of the HCBS Access Act, coverage of integrated day services, personal care attendants, direct support professionals, home health aids, private duty nursing, homemakers, chore assistance, companionship services, support for caregivers and many other services that help aging adults and people with disabilities stay in their homes would all be mandatory under Medicaid. States would receive a 100 % FMAP to cover those services...

A draft bill by Rep. Thomas Suozzi (D-N.Y.) would create a federal long-term care insurance program, funded by payroll taxes.
"We have no system in this country to pay for long-term care right now," said Katie Smith Sloan, president and CEO of LeadingAge, which represents thousands of nonprofit organizations providing services for aging adults, including adult day centers, assisted living, home care and nursing homes.
"Right now, most care is paid for by family members who deplete their savings, or older adults themselves, they deplete their savings, become impoverished, and go on Medicaid."
A public financing system, like one proposed by Suozzi could "help people pay for the services they need in the setting that makes sense for them," she said.

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Tell CMS and Hospice Leaders What You Think About Recent Changes and Proposals

  • Proposals related to the Election Statement Addendum and CoP Changes. Survey available HERE.
  • Proposals that will impact Hospice Quality Measures and the Hospice Quality Reporting Program.  Survey available HERE.
  • Request for input on Hospice Utilization Trends and Change to the Labor Shares of the hospice payment rates.  Survey available HERE

COVID-19 Updates

Pfizer Says FDA Will Soon Authorize COVID-19 Vaccine For 12-15 Age Group 

Pfizer has indicated that their COVID-19 vaccine could be approved by the FDA for emergency approval in the 12-15 year old demographic as early as next week! Additionally, it could be approved for use in those who are 2+ year-old by this Fall. 

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22% of New U.S. COVID Cases are in Children. Why?

One year ago, child COVID-19 cases made up only around 3% of the U.S. total. Last week, the American Academy of Pediatrics (AAP) reported that  children represented 22.4% of new cases reported in the past week (71,649 out of 319,601 cases).

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2 in 5 American adults fully vaccinated as daily average of new Covid cases falls below 50,000

About 2 in 5 American adults are now fully vaccinated for Covid-19, Centers for Disease Control and Prevention data shows, as the rate of new coronavirus infections continues to decline.

The U.S. is averaging 2.4 million reported vaccinations per day over the past week, down from a high point of 3.4 million daily shots on April 13.

The rate of new infections is also declining. The country is reporting an average of 49,000 cases per day, according to data from Johns Hopkins University, down from more than 70,000 just a few weeks ago.

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Reaching ‘Herd Immunity’ Is Unlikely in the U.S.

The New York Times reports, “Now, more than half of adults in the United States have been inoculated with at least one dose of a vaccine. But daily vaccination rates are slipping, and there is widespread consensus among scientists and public health experts that the herd immunity threshold is not attainable — at least not in the foreseeable future, and perhaps not ever. Instead, they are coming to the conclusion that rather than making a long-promised exit, the virus will most likely become a manageable threat that will continue to circulate in the United States for years to come, still causing hospitalizations and deaths but in much smaller numbers.”   


CMS HOPE instrument Webinar (Registration Required)

Wednesday, May 12th (12:00 – 1:00 p.m. MT)

The Centers for Medicare & Medicaid Services (CMS) will host a webinar to share updates on the Hospice Outcomes & Patient Evaluation (HOPE) assessment.

During this webinar, CMS subject matter experts will discuss the:

  • · HOPE background and objectives
  • · HOPE development and testing updates

CMS subject matter experts will answer questions at the end of the webinar, as time permits.

Registration Link:

Participation Information

After you register, you will receive a dial-in number and webinar link. You will not be able to share your registration information as it will be unique to you. Please check your spam filter if you do not receive an email confirmation.


Democrats’ Push to Lower Medicare Age Raises Hopes, Concerns

Bloomberg By Tony Pugh | April 28, 2021 5:32AM ET

Congressional Democrats appear to have found common ground in a proposal that has animated both their progressive and moderate factions: lowering the Medicare eligibility age from 65 to 60—or even lower.
Supporters want to help fund the benefits expansion with $456 billion that Medicare could save over 10 years through President Joe Biden’s plan to let the program negotiate its own drug prices.
After the massive loss of jobs and employer-based health coverage due to Covid-19, Democrats say public support for their plan is strong. A recent Gallup poll found roughly 46 million Americans couldn’t pay for quality health care if they needed it. And even before the pandemic struck, 77% of Americans, including 69% of Republicans, favored letting adults ages 50 to 64 buy into the Medicare program, according to a January 2019 poll by the Kaiser Family Foundation.
Getting their policy goals accomplished, however, will still prove to be a heavy political lift.
Congressional Republicans have railed against expanding federal health-care programs and have shown no signs of budging. The powerful pharmaceutical lobby opposes Medicare negotiating its own drug prices. And “simply lowering Medicare’s eligibility age does not solve the core problem of affordability and would put at risk the existing coverage so many Americans rely upon,” David Allen, a spokesman for America’s Health Insurance Plans, said in a statement.

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