|
|
MEDPAC Recommends Substantial Reduction to Home Health Payments
The Health Group, LLC
MedPAC’s March 2023 Report to Congress included the following recommendation:
“Our review of payment adequacy for Medicare home health services indicates that access is more than adequate in most areas and that Medicare payments are substantially in excess of costs. Home health care can be a high-value benefit when it is appropriately and efficiently delivered. Medicare beneficiaries often prefer to receive care at home instead of in institutional settings, and home health care can be provided at lower costs than institutional care. However, Medicare’s payments for home health services are too high, and these excess payments diminish the service’s value as a substitute for more costly services. On the basis of these findings, the Commission recommends that, for calendar year 2024, the Congress should reduce the 2023 base rate by seven percent (7%)."
The recommendation is largely justified by MedPAC on the basis that in 2021 the average cost of a thirty (30) day episode of care decreased by 2.9%, Medicare’s payment per in-person visit increased by 17.6%, and the Medicare margin for freestanding agencies averaged 24.9%, a historical high.
MedPAC acknowledges that home health care can be provided at lower costs than institutional care; however, the excess payments diminish the service’s value as a substitute for more costly services.
Amazingly, the number of home health agencies continues to decline as follows:
- 2018 11,699
- 2019 11,569
- 2020 11,556
- 2021 11,474
Since 2013, the number of home health agencies has decreased by over 10%. In fact, not only have the number of agencies declined, the number of Medicare fee-for-service (“FFS”) beneficiaries using home health services has declined as well. MedPAC describes the reduction as follows:
“More Medicare beneficiaries are enrolling in Medicare Advantage, reducing the demand for FFS Medicare services. In addition, aggregate and per capita hospitalizations, which are a common source of referrals to home health care, have declined in recent years.”
The Report briefly discusses the increase in the use of telehealth services. CMS is now requiring agencies to report telehealth services.
In 2023, CMS implemented a permanent reduction to the thirty (30) day period base rate of 3.925%, half of the amount calculated to maintain budget neutrality. Even if the base rate is reduced by an additional 3.925%, MedPAC believes additional decreases to the base payment rate are needed due to the margins being reported by agencies.
The MedPAC Report is available here. |
|
New Research Shows Hospice Care Reduces Medicare Costs - Member Toolkit
Joint Letter from NAHC and NHPCO
Dear Friends,
We are writing to you together as leaders from NAHC and NHPCO to let you know about important new research conducted by NORC at the University of Chicago that shows patients’ use of hospice care contributed to $3.5 billion in Medicare savings in 2019. This confirms what many of us have always believed – that hospice not only improves the lives of patients and their families, but also provides excellent value for the taxpayer.
The report, the Value of Hospice in Medicare, is the most comprehensive analysis of administrative and enrollment claims data for patients in Medicare and Medicare Advantage. It will be published tomorrow, March 22, at 5 a.m. ET, and we wanted to give you a sneak peek.
Key findings from the report include:
- Medicare spending for those who received hospice care was $3.5 billion less than it would have been had they not received hospice care.
- Hospice is associated with lower Medicare end-of-life expenditures when hospice lengths of stay are longer than 10 days.
- Hospice stays of six months or more result in savings for Medicare.
- Hospice care is associated with increased satisfaction and quality of life, improved pain control, and reduced physical and emotional distress.
Again, the report will go live tomorrow morning at 5 a.m. ET. At that point, you will be able to find a full suite of resources at: www.nahc.org/hospiceworks or www.nhpco.org/hospiceworks, including:
- Full Report: Value of Hospice in Medicare, March 2023
- Joint NAHC/NHPCO press release, March 2023
- Executive Summary: Value of Hospice in Medicare, March 2023
- Report Slides: Value of Hospice in Medicare, March 2023
- Infographic: The Value of Hospice: Better Care, Lower Cost
- Member Toolkit (NAHC and/or NHPCO members only)
The toolkit includes a sample letter to the editor, sample social media posts, and more, so you can help spread the word about the Value of Hospice. We encourage you to read the included materials carefully and determine how best you can make use of them for your organization and for the millions of Americans who depend upon and provide hospice care.
Warm regards,
Ben Marcantonio, NHPCO Interim CEO
Bill Dombi, NAHC President
Additional Resources:.
|
In Win For Home-Based Care Providers, Health Care Workforce Bill Passes
Home Health Care News | By Patrick Filbin
A bill that passed Wednesday on the state level is being touted as a potential blueprint to mitigating home-based care workforce shortages nationwide.
In Frankfort, Kentucky on Wednesday, Gov. Andy Beshear passed the Kentucky Healthcare Workforce Development Act, legislation that aims to combat workforce shortages by building a public-private partnership that is designed to increase workforce training and education initiatives.
Joanne Cunningham, the CEO of the Partnership for Quality Home Healthcare (PQHH), told Home Health Care News this week that the bill felt different than others, in a positive way.
“It’s a public, private partnership that engages the private sector like health care organizations, insurers and others, as well as the government to try to incentivize all entities to work together on this,” Cunningham said. “I think that’s one of the reasons there’s such an appeal, certainly in the Kentucky state government, but also in Washington, D.C.”
The Kentucky legislation creates an investment fund with two primary programs. The first is a matching fund where, for every dollar a private-sector partner dedicates to the fund, a match is made by an educational program to fund scholarships for health care professionals.
The second program is designed to reward excellence among health care educational and training programs through certain benchmarks and measurements.
Earlier this month, the U.S. Senate sent out a request for information (RFI) for solutions to the national health care workforce crisis. PQHH was one of many organizations that submitted a letter suggesting solutions for these issues.
One of the solutions PPQH prosed was the bill from Kentucky.
“I’ve heard a number of members of the U.S. House and Senate recently talk about bipartisan solutions being the way we should be approaching these thorny policy issues,” Cunningham said. “The Kentucky proposal certainly lands squarely in that category and I think it’s getting a lot of interest for that reason, among many others.”
Read Full Article |
Medicare Advantage Value-Based Insurance Design (VBID) Model to be Extended
The Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model will be extended for calendar years 2025 through 2030 and will introduce changes intended to more fully address the health-related social needs of patients, advance health equity, and improve care coordination for patients with serious illness.
The CMS Innovation Center looks forward to sharing more information on model updates when available. For more information on the current model design, see our overview CY24 RFA fact sheet. You can also contact the model team at [email protected]. |
New OASIS-E Resources Available: GG0170C, GG0170L, and GG0170P Video Tutorials
The Centers for Medicare & Medicaid Services is releasing short video tutorials to providers in the LTCH setting. These 5-minute videos are designed to provide targeted guidance using simulated patient scenarios to assist providers in coding GG0170C. Lying to Sitting on Side of Bed, GG0170L. Walking 10 Feet on Uneven Surfaces, and GG0170P. Picking Up Object. To access the videos, click on the links below:
If you have questions about accessing the resources or feedback regarding the trainings, please email PAC Training. Content-related questions should be submitted to the LTCH QRP Help Desk. |
|
|
|
|
<< first < Prev 51 52 53 54 55 56 57 58 59 60 Next > last >>
|
|
Page 53 of 108 |
