In The News

The Future for Senior Care Within Medicare 

McKnight’s Home Care
 
This much is known: The current state of Medicare does not adequately support the needs of many of the aging baby boomers. For those who require a more hands-on approach to care, their coverage is considerably lacking.
 
Adults who are in need of assistance with basic daily activities such bathing and grocery shopping are left to their own devices, which often equates to the need for a family member to step in as a caregiver. While this can be an advantageous option, it can also lead to burnout in the long term. Thankfully, we, as home healthcare providers, are closing the gap as we offer options that allow for as much as 24-hour care.
 
How is care covered currently?
 
Currently, senior care is financed through various means, including private pay, auto insurance (PIP), aide and attendance (through the VA), long-term care insurance and limited coverage provided by Medicare for home healthcare. In most cases, nurses are accessible for a quick check-in and are on their way. This leaves little to no opportunity for help with the various needs of the patients, hence the Medicare care gap we are witnessing.
 
As of 2023, Medicare primarily covers home health care services that are considered skilled services. This includes medical services provided by healthcare professionals such as nurses and therapists. Medicare provides coverage for up to nine weeks at a time, subject to specific eligibility criteria. However, as we noted above, Medicare does not cover non-skilled personal care services, which are essential for seniors who require assistance with activities of daily living and instrumental activities of daily living.
 
To improve is to change; to be perfect is to change often.
Winston Churchill
 
Expanding Medicare coverage for non-skilled care
 
Unsurprisingly, there is a growing demand for coverage of non-skilled home care services to promote seniors’ independence and well-being. As the need for these services continues to rise, there is a possibility of expanding Medicare coverage to include non-skilled home care. A development such as this would significantly enhance the affordability and accessibility of senior care services for Medicare beneficiaries. Currently, funding these services is difficult for many families, and as a result, many families lack the care they need for their loved ones. Unfortunately, there is no concrete evidence that this change will take place at any point in the future, though it’s likely that countless families are calling for this.
 
The future of senior care within the Medicare realm is more than likely to witness a greater integration of technology and telehealth solutions. Following the pandemic, both seniors and caregivers were able to witness the power of telehealth. Seniors who struggle to move about easily were able to remain in the comfort of their own homes for many medical appointments.
 
This has continued to transform the healthcare industry as a whole, with no sign of looking back. In fact, according to a recent survey conducted among physicians primarily serving Medicare fee-for-service and Medicare Advantage patients, it is projected that by 2025, an estimated $265 billion worth of care services for beneficiaries could be transitioned from traditional facilities to home-based settings...
 
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Hospice and Home Health Accreditation Intensives

July 25-28th  

These back-to-back Hospice and Home Health Accreditation Intensives are an interactive and engaging learning opportunity for our CHAP Hospice and Home Health Accreditation customers. Regardless of what stage of the accreditation process you are in or what role you have in the organization, this training can help you stay in compliance! 

These events will focus on: 

  • The accreditation process
  • The CHAP accreditation Standards
  • The most cited deficiencies  
  • Strategies to implement improved compliance within your own organization

Register for Hospice

Register for Home Health

 

Home Health Providers See Age-Friendly Accreditation As Competitive ‘Differentiator’

Home Health Care News / By Andrew Donlan
 
Last year, the Community Health Accreditation Partner (CHAP) received part of a $2.3 million grant from The John A. Hartford Foundation (JAHF) to bring the Age-Friendly Health Systems movement to home-based care.
 
Almost a year later, home health providers have implemented the framework – including Enhabit Inc. (NYSE: EHAB) and Compassus – and are seeing it as a potential differentiator moving forward.
 
“It’s competition in a way that makes everybody better,” Bud Langham, the EVP of clinical excellence and strategy at Enhabit, told Home Health Care News. “You can see that in the Age-Friendly Health Systems, there’s thousands of organizations who’ve already gone through a similar process on the inpatient side. You don’t want to be that one system in a marketplace that hasn’t been certified age-friendly. My hope is every single market where we achieve this certification, it raises the bar so that everybody has to step up.”
 
Based in Dallas, Enhabit provides home health and hospice services across 252 home health locations and 105 hospice locations in 34 states.
 
The age-friendly framework is supposed to elevate care for patients, but in a way that also benefits their families, referral sources and payers. It concentrates on “what matters”, medication, mentation and mobility – the “four Ms.”
 
As more care is moved to the home, age-friendly advocates – namely CHAP – believe this is a way to elevate the industry as it gains a brighter spotlight. Beginning in April, home health providers across the country have had the option to achieve a certification for Age-Friendly Care at Home.
 
“The only way we can really move the needle on outcomes is through patient involvement,” CHAP COO Teresa Harbour told HHCN. “And this is exactly what care this does, it gets that patient involved in their care. This is a perfect opportunity for organizations to provide that staff education on how to engage patients in their care and how to talk to them and determine what matters to them.”
 
A value-based care driver
 
Providing care in line with a patient’s goals was always sensical. But, the four Ms around Age-Friendly Care at Home fit in perfectly with the Home Health Value-Based Purchasing (HHVBP) Model as well.
 
Part of the calculation behind HHVBP is patient satisfaction scores. If patients are receiving care that they believe is specifically tailored toward them, providers are much more likely to receive high scores from those patients…

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Colorado Enacts Legislation Restricting Employers from Requesting Age-Related Information from Job Applicants

Health Care Association of America (HCAOA)

On June 2, Colorado Gov. Jared Polis signed into law Senate Bill 23-058, the Job Application Fairness Act (JAFA), prohibiting employers from inquiring about a job applicant’s age during the hiring process. JAFA’s enactment adds to the requirements and proscriptions Colorado has implemented in the hiring process, including a “ban-the-box” restriction on inquiring about criminal histories and requiring the inclusion of salary and benefits information in job postings.

Click here to learn more from HCAOA partner Littler.

 

Dombi: In Advance of Proposed Rule, Agencies Fighting ‘Medicare Home Health War’

McKnight’s Home Care | By C. MAX BACHMANN
 
National Association for Home Care & Hospice President William Dombi issued a frank assessment of the state of home healthcare Thursday in advance of the release of the Centers for Medicare and Medicaid Services’ proposed payment rule for 2024.
 
“There is intense congressional action going on,” he said Thursday in a webinar hosted by the Polsinelli law firm. “Regulatory response is in play. Even litigation is on the agenda as well. This is the equivalent of a Medicare home health war at this point in time.”
NAHC and other associations are anticipating a rate cut in the proposed rule. 
 
“We’re days away from seeing the proposed payment rule for 2024,” he said. “There’s a lot we’re watching for there with potential for a proposed rate cut that ranges from low single digits to mid teens [that would] really be putting the delivery of care in jeopardy.”

The permanent behavioral adjustment of -3.925%, which went into effect this year, has contributed to staffing shortages, which have resulted in a drop in hospital-to-home health conversion rates, he told McKnight’s Home Care Daily Pulse earlier. A temporary rate adjustment — so-called clawback payments related to the Patient-Driven Groupings Model — also could surface in the proposed rule. It could total billions of dollars.
 
Medicaid Access Rules
 
Home care already is dealing with the aftermath of two other significant rules from CMS proposed in April
 
Ensuring Access to Medicaid Services (Access NPRM) and Managed Care Access, Finance, and Quality (Managed Care NPRM) would require home- and community-based services (HCBS) to publish average hourly rates paid to direct care workers and strengthen person-centered service planning, among other provisions. Perhaps the most controversial requirement is that 80% of Medicaid payments for personal care, homemaker and home health aide services be spent on compensation for direct care workers.
 
“Essentially, the states would report data each year on the proportion of the total amount of Medicaid expenditures they had for these three services and the proportion of that that was provided to the workers,” NAHC Director of Medicaid HCBS Damon Terzaghi explained Thursday. 
 
Providers have voiced their displeasure with this measure. Last week, Addus HomeCare CEO Dirk Allison noted that the rules would “disproportionately” affect caregivers in states that pay them less and put “a vast majority of the small mom-and-pops” out of business. 
 
Terzaghi expressed frustration that the 80/20 measure is distracting from the other positive provisions within the text.
 
“We’re partially frustrated about this 80/20 proposal not just because of the challenging policy and, we think, the unsupported mandate they’re putting on providers, but also because it’s sucking the oxygen out of the room for so many potentially positive changes that were included in this regulation,” he said. 
 
Angelo Spinola, Polsinelli’s home health, home care and hospice chair, pointed out to providers that the rules are not yet final and that there is an open comment period until July 3. He also noted that associations and providers are working on issuing statements.
 
“This is one of those areas where a loud and uniform voice is going to make a significant difference,” he said. “This isn’t going to be a one-and-done type of situation. The rule would not actually go into effect until four years after the final publication.”…

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