IRS Issues Standard Mileage Rates for 2024

SESCO Management Consultants

• The Internal Revenue Service (IRS) has released the optional standard mileage rates for 2024.
• The standard mileage rates for 2024 are: 67 cents per mile for business uses; 21 cents per mile for medical uses; and 14 cents per mile for charitable uses.
• FAVR allowance for 2024. For purposes of the fixed and variable rate (FAVR) allowance, the maximum standard automobile cost for vehicles places in service after 2023 is $62,000. Employers can use a FAVR allowance to reimburse employees who use their own vehicles for the employer’s business.

Home Health Agencies Grapple With ‘Acuity Creep’ As Patient Needs Become More Complex

Home Health Care News | By Patrick Filbin 

In recent years, due to factors like the pandemic and the reinvention of hospitals, home health agencies are having to take care of much more complicated patients.

As the demand for home-based care continues to rise, so does the need for more intensive care plans as patients continue to be sicker and more complex.

Home health agencies are feeling this “acuity creep,” and they’re adjusting. But at times, it’s hard to keep up.
“When I’m talking about acuity creep, I’m thinking about how much need do the patients in our care models require?” Michael Johnson, president of home health and hospice at Bayada Home Health Care, said. “It’s not just medical needs, either — there’s a social need as well. We’ve seen a definite increase in the needs of our patients.”

The Moorestown, New Jersey-based Bayada is one of the largest home health providers in the country. It has over 360 locations across 23 states and six other countries.
In order to find out if the acuity creep had affected Bayada, Johnson recently dug through the last four years of PDGM data for patient diagnoses and found a noticeable decrease in categories like musculoskeletal rehab and an increase of patients who needed neuro rehab, cardiac and complex behavioral health.

The last three categories can be filed under “more need,” Johnson said. With the need for intense care comes the need for more nurses, home health aides and other caregivers.
“When they’re sicker — as we’ve seen it — we need nursing care for the same person,” Johnson said. “In the case where there’s a nursing shortage, that becomes a bit of a crunch, so from a staffing perspective, that’s been a challenge. When I think about need, I think about workforce.”

Eric Gommel — chief strategy officer at Virginia Health Services — is also focused on workforce development due to this acuity creep.

Virginia Health Services is a provider of home health, palliative and hospice care, and also offers senior housing and other nursing services.

The company has invested heavily in apprentice programs and career ladder initiatives as a way to combat the acuity creep.
“They’re the primary people taking care of our seniors,” Gommel said. “It’s the sad reality of our society that we expect the most out of our children and these caregivers – and we pay them the least.”

Many of the issues that arise when trying to take care of more complex patients, Gommel has found, are in the preparation and education of staff members…

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Panel Considers Potential Changes to Home Health Model

American Hospital Association
 
The Centers for Medicare & Medicaid Services Dec. 29 released a report on the Expanded Home Health Value-Based Purchasing Model that summarizes input from the first two meetings of a technical advisory panel considering potential refinements to the model’s methodology, measures and approach to health equity. Launched in 2022, the expanded model includes Medicare-certified home health agencies in all 50 states and in U.S. territories. The model’s measure set currently uses data already reported by HHAs through the Home Health Quality Reporting Program or Medicare claims and Home Health Care Consumer Assessment of Healthcare Providers and Systems surveys. 

The 2024 Adult Vaccine Schedule Changes Are Here

Medscape | By Sandra Adamson Fryhofer, MD

This segment of Medicine Matters by Sandra Fryhofer, MD, highlights updates in the 2024 Advisory Committee on Immunization Practices (ACIP) Adult Immunization Schedule.

The biggest change for 2024 is that you don't need to wait till January 1, 2024, for these schedules go into effect. Both schedules were published and became available in November 2023 and became effective immediately. They include ACIP recommendations approved by the Centers for Disease Control and Prevention (CDC) director through October 23, 2023.

Subsequent recommendations (before publication of the 2025 schedule) will be added to the addendum, a new Step 5, Section 5 in the schedule. The addendum should make Affordable Care Act (ACA)–compliant insurance plans cover ACIP-recommended immunizations sooner.

This year's schedule includes more vaccines with new recommendations and new color code keys for the schedule's vaccine tables. The newest vaccine additions to the schedule include respiratory syncytial virus (RSV) vaccines, the mpox vaccine (Jynneos), a new MenACWY-MenB combo vaccine (Penbraya), and the new 2023-2024 formulation of the updated COVID vaccine (both mRNA and protein-based adjuvanted versions).

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