In the News

Hospital-At-Home, Telehealth, DME Reimbursement Top Year-End Home Care Priorities

McKnight’s Home Care / By Adam Healy

Home care advocates are advancing numerous home care advocacy priorities in the final days of 2024. They are focusing on telehealth, hospital-at-home and durable medical equipment (DME).
 
Last week, the Long-Term Post-Acute Care Health Information Technology (LTPAC Health IT) Collaborative, which includes LeadingAge as a member, sent a letter to Congress asking for an extension of telehealth flexibilities enacted during the COVID-19 pandemic. These flexibilities, which allow providers to furnish virtual care services over state lines, among other capabilities, will expire Dec. 31 without congressional action.
 
“Extending telehealth flexibilities is a necessary step to ensure Medicare’s most vulnerable, frail patients have access to high-quality healthcare regardless of their location or economic status,” LTPAC Health IT wrote. “We strongly urge you to support these policy extensions and help us continue to provide essential healthcare services to those who need them most.”
 
DME advocacy
 
Meanwhile, also last week, the ITEM (Independence Through Enhancement of Medicare and Medicaid) Coalition, of which the American Association for Homecare is a member, sent a letter to Senate and House Leaders urging support for legislation that would improve reimbursement rates for most home medical equipment products. HR 5555, introduced in September by Rep. Mariannette Miller-Meeks (R-IA), would provide a 90/10 blended Medicare reimbursement rate for many DME products.

A similar bill introduced by Sens. John Thune (R-SD) and Debbie Stabenow (D-MI), S. 1294, would implement a 75/25 blended rate. These bills are necessary to ensure providers’ financial security and patients’ continued access to DME products, according to the coalition.

“Provisions from these bills, taken together, would ensure continued beneficiary access to DME services and devices, provide a much-needed measure of relief and stability for nonrural, non-CBA suppliers, and also have positive impacts on reimbursement levels from other payers who pattern their reimbursement levels off the Medicare fee schedule,” the ITEM Coalition said in its letter.

Impact in Washington

This advocacy has resonated with some lawmakers. Currently, Republicans and Democrats are trading year-end legislative proposals that would extend telehealth flexibilities as well as the Acute Hospital Care at Home waiver, which has enabled health systems across the country to launch successful hospital-at-home programs, according to new reports by InsideHealthPolicy.  

Steve Landers, MD, chief executive officer of the National Alliance for Care at Home, said last month that his organization’s focus remains on securing better reimbursement and reducing cumbersome regulations for care-at-home providers before 2024 ends. Looking ahead, industry stakeholders have expressed confidence that President-elect Donald Trump’s return to the White House, as well Republican majorities in Congress, could help home care providers advance various key policy goals.
 

CMS Approves Revised Home Health Change of Care Notice

Alliance Daily

The Office of Management and Budget (OMB) has approved the Home Health Change of Care Notice (HHCCN) for 3 years. There were no substantive changes made to the HHCCN form or the form instructions. CMS did make plain language and information design changes to the form and form instructions according to our Office of Communications (OC) recommendations. OC’s recommendations in plain language and information design are research-based best practices. The OC worked to apply the same research-based standards across all products and channels to make sure our language, messaging and branding are consistent.

CMS has also provided the HHCCN in 3 additional languages with this package approval.  Those languages, along with English and Spanish, include Chinese, Vietnamese and Korean.  

Since the current HHCCN does not expire until 12/31/2024, you may continue to use the HHCCN (OMB expiration date of 12/31/2024) until 1/31/2025 however, you will be required to use the newly approved HHCCN (OMB expiration date of 11/30/2027) on 2/1/2025.  The newly OMB approved HHCCN form (expiration date of 11/30/2027) may be found in the downloads section.  FFS HHCCN | CMS
 

Hidden Changes: What Home Health Providers May Have Missed In The Final Rule

Home Health Care News / By Audrie Martin

On Nov. 1, the Centers for Medicare & Medicaid Services (CMS) issued the final home health payment rule for 2025, updating Medicare policies and rates for home health agencies. 

But while the payment-related information grabbed headlines, there are plenty of other changes to home health care within the rule that providers should be paying attention to. 
CMS estimated that Medicare payments to agencies in 2025 would increase by 0.5%, or $85 million, compared to 2024. In addition to the slight payment increase, the rule introduced other changes for HHAs that may impact their business practices.

“This is not where we want to be,” William A. Dombi, president emeritus of the National Alliance for Care at Home, said during a recent webinar. “We are on a slippery slope toward potential disaster. We projected this would happen when we examined CMS’ methodology for budget neutrality. All CMS has done is mitigate the situation, rather than create a foundation for restoring the home health benefit to its intended state.”

Elara Caring CEO Scott Powers echoed this sentiment and urged CMS to reevaluate its payment model. 

“While CMS’ 2025 payment adjustments attempt to address some challenges faced by home health providers, the current approach remains inadequate,” Powers told Home Health Care News. “The budget neutrality methodology continues to undermine the fundamental purpose of home health care, limiting access for the seniors who rely on these services the most. We urge CMS to prioritize a payment model that genuinely reflects the value of home health care.”

With a presence in 18 states, Elara Caring provides an array of home-based care services across more than 200 locations, serving more than 60,000 patients. 

“CMS’ decision to implement a -1.975% permanent projected adjustment to home health payments is deeply concerning,” Compassus CEO Mike Asselta told HHCN. “This is particularly troubling as the demand for these services continues to rise. Concurrently, new conditions of participation increase the administrative burdens on home health agencies without adequately addressing critical issues like access to care.”

Based in Brentwood, Tennessee, Compassus also offers a wide range of home-based care services including home health care, home infusion, palliative care, hospice care and home-based high-acuity care, with more than 270 locations across 30 states.

Bud Langham, the executive vice president of clinical excellence and strategy for Enhabit Inc. (NYSE: EHAB) , expressed significant concern about the 2025 home health final rule. 
“The most pressing issue is yet another cut to home health reimbursement,” he said. “This marks the third consecutive implementation of negative permanent adjustments, along with planned temporary adjustments that are still pending. Congress needs to take action; over 60 million Medicare-eligible Americans are counting on it.”

In addition to the disappointing annual payment update, CMS has finalized several other changes that will affect home health providers starting in 2025 and beyond…

Read Full Article
 

CMS Floats Five Home Health CAHPS Changes

McKnights Home Care / By Adam Healy
 
The Centers for Medicare & Medicaid Services is weighing five changes to the Home Health Consumer Assessment of Healthcare Providers and Systems (CAHPS). The proposed measures could affect home health providers’ Medicare star ratings and scores under Home Health Value-Based Purchasing (HHVPB).

CMS disclosed last week the five new CAHPS additions in its Measures Under Consideration (MUC) list for 2024. They include: Care of Patients; Communications Between Providers and Patients; Talk About Home Safety; Review Medicines; and Talk About Medicine Side Effects. 

“Providers should be aware that the existing multiquestion measure around ‘specific care issues’ is being changed to create three, new single-question measures on home safety, review of medicines (for prescriptions and over the counter medications), and talking about medicine side effects,” Katy Barnett, director of home care and hospice operations and policy at LeadingAge, told McKnight’s Home Care Daily Pulse Thursday in an email. “These changes will require agencies to really focus on medication reconciliation and side effect reviews as well as occupational visits to create a safe home environment.”

Barnett noted that CMS’ proposed changes suggest that the agency aims to remove repetitive and confusing questions that are currently in the Home Health CAHPS survey. Two of the measures under consideration, Care of Patients and Communication Between Providers and Patients, will affect HHVBP and providers’ Star Ratings, she said. 

CMS is soliciting feedback on the proposed measures through Dec. 30, and the agency will likely provide an update on their status in next year’s home health rule.

“CMS is required to go through formal notice and comment rulemaking to implement any changes,” Barnett explained. “As we’ve often seen with the MUC list process, CMS will often move forward with proposing and finalizing measures despite concerns from members of the consensus-building body’s advisory groups. We’ll know more about CMS’ intent with these changes in the summer when the CY2026 Home Health Proposed Rule is issued.”

She added, “We can also hope that CMS takes steps to change the administration of the survey as they did in hospice by extending the time the survey is in the field or creating a web mode. We’ll know more in future rulemaking.”
 

Home Health 2025 Outlook Webinar

January 8 at 10 a.m. MT

The year ahead is likely going to be another exciting one for home health providers, fraught with challenges and filled with opportunity. They’ll have to consider how to mitigate fee-for-service rate cuts, and also how they will win better contracts with Medicare Advantage plans. Another consideration is how to find ways to grow with staffing constraints, and also hit the right chords with technology adoption.

The home health landscape changes every year. Prepare for 2025 with this webinar, as we are joined by top minds from the industry.

Register Now
 
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