In The News

‘Time To Claim The Future’: The Hospital-At-Home Model’s Chance To Decentralize US Health Care

Home Health Care News | By Andrew Donlan

Hospital-at-home care has a chance to become a mainstay in the larger home-based care ecosystem. As its stakeholders aim to get it there, there are a few factors that need to be considered. 
 
Firstly, without payment, there is no hospital-at-home model. Early pioneers of the model in the U.S. know that all too well. 
 
But Medicare providing adequate payment for hospital-at-home care during the public health emergency (PHE) was a major first step to get other payers to follow. The Centers for Medicare & Medicaid Services’ (CMS) Acute Hospital Care at Home waiver has already been extended through 2024 – it was initially supposed to expire at the end of the PHE – and now is up for another extension. 
 
Earlier this month, Sens. Tom Carper (D-Del.) and Tim Scott (R-S.C.) introduced a bill that would push back the expiration date of the waiver program by five years. An extension bill was also introduced in the House
 
That would make for an obvious tailwind for hospital-at-home stakeholders. It not only would keep the payment valve open for current hospital-at-home programs, but also give health systems interested in the model the assurance that investment will be worth their time. 
 
Additionally, earlier this year, Sens. Marco Rubio (R-Fla.) and Tom Carper (D-Del.) introduced the At Home Observation and Medical Evaluation (HOME) Services Act, which would allow providers to admit patients into hospital at home prior to being admitted in the brick-and-mortar hospital
 
The Acute Hospital Care at Home waiver taking on a wider scope, more payers following Medicare’s lead and more home-based care providers becoming involved isn’t just good news for the hospital-at-home model, though. 
 
It pushes forward the idea that the home can eventually be the epicenter of health care in the U.S., which is an idea that many home-based care stakeholders are behind, but also a major departure from the current system. 
 
“One may ask why a five year extension, as opposed to something made permanent,” Medically Home CEO Rami Karjian recently told me. “We think Medicare wants to go the bundled route for making this permanent. We think they have this vision, like with BPCI-A, acute and post-acute care integrated and paid for together. That’s where we think this is 
ultimately going to go.” …

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More Than a Third of Healthcare Organizations Aren’t Prepared for Cyberattacks: Report

Healthcare Dive | By Sydney Halleman

Thirty-seven percent of healthcare organizations did not have a cyberattack contingency plan in place, despite half having experienced an attack, according to a new survey from Software Advice.

Dive Brief:

  • More than one in four ransomware attacks in healthcare impact patient care, according to a new survey out this week from advisory firm Software Advice.
  • About half of healthcare organizations that experienced a ransomware attack said the breach impacted patient data — and 34% said they failed to recover the data after the attack.
  • Cyberattacks can result in pricey downtime and delay critical procedures, the report said, but only 63% of companies report having a cybersecurity response plan in place.

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Uber Reveals New Product to Help Caregivers and Home Health Agencies

McKnight’s Senior Living | By Adam Healy
 
Rideshare technology firm Uber recently announced a new service aimed at addressing the logistical challenges faced by family members and home care agencies when providing care for older adults aging in place.
 
Uber Caregiver, revealed last week, will allow users to designate a primary caregiver who can request transportation and deliveries on the user’s behalf. The service aims to alleviate some of the logistical burdens of caregiving, like coordinating rides to appointments or arranging grocery deliveries.
 
“The notion here is to be able to engage a caregiver in a loved one’s care journey,” Zachary Clark, chief growth officer of Uber Health, told McKnight’s Home Care Daily Pulse in an interview. “We’re really kind of cognizant and aware of the 50 million Americans across the United States that identify themselves as caregivers.”
 
He added, “If the care receiver isn’t an Uber user today, but Mom and Dad or a sibling is, this is a way to kind of help an individual navigate [their care].”
 
The service will begin rolling out by late July or early August, Clark said. By the end of 2024, Uber Health plans to add tools like over-the-counter medicine delivery capabilities to the Uber Caregiver platform. The company has already ventured into health product delivery services; Uber recently partnered with Reperio, a technology startup, allowing drivers to deliver health screening kits to and from patients’ homes.
 
Users will also be able to use healthcare benefits to pay for Uber Caregiver services. Uber Health is working with Medicare Advantage, Medicaid and commercial payers to allow their members to use their plan’s benefits to order rides or deliveries. This feature also gives consumers better visibility into their health plan’s offerings, which can often be confusing to navigate, Clark noted.
 
“You might be accessing an Uber, but that benefit might be managed through a third party broker. We want to be able to tell you that you have 22 out of your 24 rides left,” he explained. “Today all of that information resides in disparate places. And so combining that in a way that helps engage the member around what they have access to, we think, can be really powerful to create the right kinds of utilization that really we should see of these benefits. “
 
Home care and home health providers are uniquely positioned to use Uber Caregiver to their advantage, Clark said. The platform can make it easier for patients to engage with care services, he noted. It also allows family members to take a more active role in their loved one’s care, thereby reducing providers’ time spent on tasks like coordinating rides and deliveries, and increasing their opportunities for face-to-face interaction.
 
“Over time, it reduces the administrative burden for a home health or home care agency carries with them,” Clark said. “So by inviting the caregiver into that experience … it requires less of that home health or personal care coordinator over time, which helps them be more efficient and spend more time with the patient.”

 

ACL Releases 2023 Profile of Older Americans

The Profile of Older Americans is a summary of the available statistics related to the older population in the United States. Principal sources of data are the U.S. Census Bureau, the National Center for Health Statistics, and the Bureau of Labor Statistics.

The Profile illustrates the shifting demographics of Americans 65 and older. It includes key topic areas such as future population growth, marital status, living arrangements, income, employment, and health.

Highlights from the Profile

  • In 2022, 31.9 million women and 25.9 million men were 65 or older.
  • People 65 and older represented 17.3% of the population in the year 2022. That percentage is expected to grow to 22% by 2040.
  • Of older adults 65 and older living in the community, 59% lived with their spouse/partner in 2023. About 28% lived alone.
  • States with the highest percentage of populations 65 and older in 2022 were Maine, Florida, Vermont, and West Virginia.
  • The 2022 median income of older people was $29,740 ($37,430 for men and $24,630 for women).
  • In 2023, 11.2 million Americans age 65 and older were in the labor force (working or actively seeking work).

The Profile incorporates the latest data available. Not all data are updated annually.

Access the Full Profile

 

CMS to Extend Review Choice Demonstration by Five Years, to Remove One of Three Choices

McKnight’s Home Care | By Liza Berger

The Centers for Medicare & Medicaid Services will be extending the Review Choice Demonstration (RCD) for Home Health Services for an additional five years, effective June 1, CMS said on the Home Health, Hospice & DME Open Door Forum call on Wednesday. The demonstration will continue in the states of Illinois, Ohio, Texas, North Carolina, Florida and Oklahoma, an official said.

“This demonstration establishes the review choice process for home health services to assist in developing improved procedures to identify and prevent fraud, protect beneficiaries from harm, and safeguard taxpayer dollars to empower patients while minimizing unnecessary provider burden,” CMS said in a FAQ sheet about the model, which began on June 1, 2019. “The demonstration helps ensure that the right payments are made at the right time for home health service through either pre-claim or post-payment review, protects Medicare funding from improper payments, reduces the number of Medicare appeals, and improves provider compliance with Medicare program requirements.”

There have been three initial choices for agencies under the demonstration, which was slated to end on May 31. As part of the extension, CMS is removing Choice 3: Minimal Review with 25% Payment Reduction from the selections. Two remain: pre-claim review and post-payment review. Palmetto GBA, which administers Part A and Part B Medicare fee-for-service claims, will be reaching out to small numbers of affected providers to select from the two remaining choices, the CMS official said on the call. Selection will start on June 17 and remain open until July 1.

“Providers who do not make an initial review choice selection will default to participate in Choice 2: Postpayment Review,” CMS said on its website about the demonstration’s extension. “Providers with less than 10 reviews at the conclusion of the current cycle, will have their results included in the next cycle’s results.”

All other home health providers in the demonstration will continue in their current review cycles and follow their regular cycle timelines. Providers who believe their current review choice presents a “hardship” and would like to change their choice should notify Palmetto by June 14, CMS stated on the website.

 
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