Help HHAU and HCAOA Pass the Homecare for Seniors Act!

The Homecare for Seniors Act is gaining serious momentum in Washington, DC, and we need your help to get it passed and signed into law!

As you may know, the bill would allow home care services to be paid for with money from a Health Savings Account. Senator Kyrsten Sinema (D-AZ), the sponsor of the bill, has formally asked Senate leaders to add this bill to an end-of-the-year package of bills, making it much more likely that it will pass.

PLEASE CLICK HERE to have a pre-written letter sent to your member of Congress and your Senators asking them to support the Homecare for Seniors Act now! Make your voice heard in Washington and help make homecare more affordable!

Thank you for your advocacy!

Now Available– Final OASIS-E Instrument and OASIS-E Changes from Draft to Final Instrument & Manual

The final OASIS-E instrument, effective January 1, 2023, is available in the Downloads section on the OASIS Data Sets page. A log of changes from the draft to final instrument and Manual is also available in the Downloads section on the OASIS Users Manuals page.  

Providers Cheer CMS Proposal to Streamline Prior Authorizations

McKnight’s Home Care | By Diane Eastabrook
 
Provider advocates are applauding a proposed rule by the Centers for Medicare & Medicaid Services that would speed up prior authorization of healthcare services by payers.
 
The proposal would require Medicare Advantage (MA) plans, Medicaid and Qualified Health Plan (QHP) issuers on the Federally-facilitated Exchanges (FFEs) to streamline their prior authorization processes. Payers would be required to respond to urgent requests for healthcare services within 72 hours and standard requests within seven calendar days. They would also be required to include a specific reason when denying requests and publicly report certain prior authorization metrics. 
 
“We are very pleased that CMS has recognized the value and importance of expediting prior authorizations in MA plans and Medicaid,” National Association for Home Care & Hospice President and CEO William Dombi told McKnight’s Home Care Daily Pulse on Wednesday. “Patient needs warrant quick and accurate decisions by payers.” 
 
The proposal also includes other administrative guardrails, including a requirement that certain payers implement standards that would allow patient data be exchanged seamlessly between payers when a patient switches coverage or when they have concurrent coverage. 
 
CMS Administrator Chiquita Brooks-LaSure said the goal of the rule is to “improve the care experience across providers, patients and caregivers — helping us to address avoidable delays in patient care and achieve better health outcomes for all.” 
 
CMS will accept public comment for the proposed rule through March 13, 2023.
 
The agency isn’t the only group in Washington taking aim at prior authorization by payers, especially among MA plans. Legislation that would require MA plans to streamline the process sailed through the House last September and is pending before the Senate. 
 
MA plans have also come under fire from government watchdog Office of Inspector General for denying and delaying services to older adults covered under those plans.

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New Report Highlights Significant Home Care Challenges, Gaps, and Opportunities Amid Growing Demand for Services

Integrated Home Care Services

Integrated Home Care Services, Inc. (IHCS), the nation's leading independent home care benefits administrator of home health, durable medical equipment (DME), and home infusion services, has released a new report highlighting the results of an in-depth survey of health plan executives.

The report entitled "Are Health Plans Prepared for Home Care's Rapid Ascent?" details findings from a survey of 47 health plan leaders familiar with their plan's home care offerings. The independent survey was conducted in September 2022 by national healthcare consultancy Sage Growth Partners.

Results show a growing recognition of the value of delivering healthcare within the home, as well as a rising demand for home-based services among patients and their family members. Ninety-one percent of survey respondents said demand for home care services has risen over the past five years—and they expect that trend to continue. That's consistent with both industry and the Centers for Medicare & Medicaid Services' projections.

Additionally, 96% of respondents indicated that home care costs have increased over the past five years, with more than one-quarter saying costs have increased more than 10%.

"Nationally, there continues to be a significant growth in demand for home care services," said Christopher Bradbury, CEO of IHCS. "This is not surprising, given the surging senior population, the popularity of home care, the advances in homecare-related technology and the significantly lower costs of home care services when compared to facility-based care."

Among other key findings in the report:

• 80% of respondents predicted the increase in home care utilization is permanent.
• Only 38% said their organization is performing "very well" when it comes to supporting the home care needs of plan members. While 60% said they do this "moderately well."
• Nearly two-thirds say executives meet rarely or occasionally to discuss home care.
• 75% said reducing the administrative burden of home care is a top benefit of delegating services to a third party. About 50% said improving service coordination is a key benefit.

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