In The News

Lawmakers Introduce Bill to Expand Home-Based Care Coverage Under Medicaid

Home Health Care News | By Joyce Famakinwa 

A number of lawmakers – including Sen. Bob Casey (D-Pa.) and Rep. Debbie Dingell (D-Mich.) – introduced a bill Thursday that would expand coverage of home- and community-based services under Medicaid.
 
The HCBS Access Act was introduced by Casey, as a companion bill to the Better Care Better Jobs Act, which was originally unveiled in 2021 and reintroduced in January.
 
“The second bill establishes a permanent funding stream to keep the infrastructure strong and to make sure we’re able to continue to pay direct care professionals at a rate that ensures qualified, reliable services in a qualified reliable workforce into the future,” Casey said during a hearing announcing the bill.
 
The bill would also provide training and support for family or informal caregivers.
 
The legislation would provide grant funding for states, allowing them to expand their capacity for home-based care services.
 
So far, the bill has already received strong support from the Partnership for Medicaid Home-Based Care (PMHC).
 
“PMHC is encouraged by Senator Casey and Representative Dingell’s efforts to continue to bring ongoing focus on the need to treat home-based services as a long-term, viable alternative to facility-based care with sufficient funding to address workforce challenges,” a PMHC spokesperson told Home Health Care News in an email. “Ultimately, we hope to see bipartisan engagement to bring this to fruition to allow us to sustain and improve important long-term supports and services for the people we serve.”

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Fight for Your Agency at NAHC's March on Washington

Home health providers are facing devastating payment cuts. The hospice community is rallying behind targeted efforts to address fraud, waste and abuse in the program. Medicaid HCBS rates continue to be woefully inadequate. Despite unprecedented demand for our services, care-in-the-home providers need more robust policy supports to address these and other pressing challenges facing our community.

This event will be held in-person with a kickoff briefing at the Kaiser Permanente Center for Total Health on March 27, 2023. BUT, you can still participate virtually, and our team will set meetings up for you on March 28, 2023.

SCHEDULE:

  • March 27th (4:00-7:00 PM) – Briefing on logistics and issues with staff and Soapbox Consulting to prep you for the day.
  • March 28th (Scheduled Appointments) – Head to Capitol Hill to meet with your members of Congress and urge them to help with these vital issues

If you do decide to send someone from your agency to attend in person or if you register to participate virtually, please let HHAC know, so that we can track how Colorado is represented.

REGISTER 

 

How Home Health Providers Can Prepare For The Survey Processes

By Joyce Famakinwa 

It’s more important than ever for home health organizations to be ready for the survey process.

In order to be prepared, providers will need to be armed with strategies that will help them come out on top.

“Even the most prepared operations are blindsided by unexpected interpretations and requirements,” Lynn Smith, senior manager on the compliance and regulatory team at SimiTree, said during a recent webinar.

 Broadly, there are a number of different kinds of surveys that are relevant to home health providers, including state surveys, the deemed status accreditation survey and the Centers for Medicare & Medicaid Services (CMS) validation survey.

“The state survey is where your State Department of Health would come and do your survey,” Smith said. “Also, there are deemed status accreditation surveys. This is when you’re using an accrediting body to do your survey. The CMS validation survey is when a CMS team, or contractor, conducts an independent survey within 60 days of the state survey to compare the results. Sometimes you may see a CMS validation survey that comes after an accrediting body does your survey.”

Prior to the survey process, it is important to make sure that the entire staff has a strong understanding of the current home health conditions of participation (CoPs).

Along these lines, providers should incorporate this education into an orientation program for new staff members. There should also be rolling updates for the current staff.

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Hospital-at-Home Steps out of the COVID-Era Through New Atrium Health, Best Buy Partnership

Fierce Healthcare | By Annie Burky

Both Atrium Health and Best Buy Health employed their respective at-home care programs during the COVID-19 pandemic when hospitals were a hotbed for the virus and providers were scrambling to provide care.

Today, the duo announced a partnership to develop a new hospital-at-home offering for a post-pandemic world.

Atrium Health launched its virtual inpatient care program to treat COVID patients from the comfort of their own homes. Best Buy Health has grown its remote care enterprise solution through a series of acquisitions and partnerships with companies like Current Health and TytoCare.

Rasu Shrestha, M.D., chief innovation and commercialization officer at Advocate Health, Atrium’s parent company, believes that the new collaboration will illuminate at-home care and expand Atrium’s current offering.

“This transition that happens from discharging a patient from a hospital to the void of their home is the dark side of the moon: It's disconnected, confusing, expensive,” Shrestha told Fierce Healthcare. “What we've been doing in the past is working through our hospital home program and manually putting together a lot of these devices. By working with Best Buy Health, we're developing the seamless connected care experience and an opportunity to truly scale this.”

Since launching its hospital-at-home program in March 2020, Atrium has met 6,300 patients at home while redirecting 25,000 hospital bed days, according to Shrestha. “In the context of traditional brick-and-mortar facilities, that’s a 100-bed hospital,” he noted.

Atrium’s at-home hospital program was initially designed for COVID and COVID-presumptive patients. Now, the suite of solutions is meeting a growing cadre of patients diagnosed with chronic cardiac conditions, chronic obstructive pulmonary disease, pneumonia, asthma, infections and other medical and postoperative conditions.

 

Payers Should Cover Home-Based Cardiac Rehabilitation Programs, Researches Argue

Fierce Healthcare | By Frank Diamond

Insurers need to rethink their coverage policies regarding home-based cardiac rehabilitation programs, according to a study published yesterday in the Journal of the American Heart Association.

In a press release, the study’s senior author Mary A. Whooley, M.D. said that “our biggest challenge in the U.S. is that home-based cardiac rehabilitation is not covered by many health insurers. Currently, Medicare only pays for on-site or facility-based cardiac rehabilitation.”

While problems persist on the supply side for providing these programs, the study also found a lack of demand.

“The biggest surprise of our analysis was how few patients chose to participate in cardiac rehabilitation,” Whooley said, a primary care physician at the San Francisco Veterans Affairs Medical Center and professor of medicine at the University of California, San Francisco.

HBCR programs focus on lifestyle changes. “However, changing behaviors is difficult, and while care facilities may offer on-site cardiac rehabilitation, many patients don’t choose to take advantage of follow-up treatment,” Whooley said.

The study, which authors tout as the first to show that home-based cardiac rehabilitation can help people with heart disease live longer, involved examining data of 1,120 patients eligible for cardiac rehabilitation at the San Francisco Veterans Health Administration between 2013 and 2018.

Excluded from the study were veterans who choose to attend facility-based cardiac rehabilitation programs or those who died within 30 days of hospitalization. Researchers compared outcomes for 490 home-based care participants to 630 patients who did not participate in the program. The patients were monitored through June 30, 2021.

Those in the home-based program had a 36% lower risk of death compared to those who did not participate.  

“Although no observational study can eliminate the possibility that healthier patients were more likely to participate in HBCR, we rigorously adjusted for confounding using an inverse probability weighted Cox regression analysis with the goal of equalizing the samples across all variables other than exposure to HBCR,” the study found. “These results suggest that participation in HBCR contributed to lower mortality among patients referred to [cardiac rehabilitation].”

The home-based rehabilitation program lasted 12 weeks and included nine coaching calls, motivational interviews and a health journal to track diet, exercise and vital signs. Participants were also given a stationary bike and a blood pressure monitor.

Patients were given physical activity goals, after consultation with a nurse or exercise physiologist. Follow-up calls were made to patients at three and six months after the program, and they were monitored an average of 4.2 years after being hospitalized.

 
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