In the News

Find Opportunities to Partner with MA Plans, Experts Advise Home Health Agencies

McKnight’s Home Care / By Diane Eastabrook

Home health agencies must leverage Medicare Advantage (MA) plans, not avoid them. That word came Tuesday from a home health consultant during a webinar for National Association for Home Care & Hospice members.

“We are at a pivotal moment,” Lindsay Doak, senior manager for BerryDunn, an accounting assurance and consulting firm, explained during a NAHC webinar highlighting the booming MA landscape. “It is a growing presence state by state, county by county. We are going to see 40 million enrollees or more over the next decade or so in Medicare Advantage plans.” 

The statistics Doak presented during the webinar bear that out. In 2007, MA enrollment comprised less than 20% of total Medicare-eligible beneficiaries. However, by last year the plans accounted for 48% of beneficiaries, according to information attributed to the Kaiser Family Foundation.

The number of MA plans has also increased nationally over the past decade. Half of Medicare beneficiaries nationwide will have access to more than 40 MA plans this year, with some having access to 75 or more plans, Doak noted. And UnitedHealthcare and Humana have the largest numbers of MA plan enrollees, with 28% and 18% of the market respectively, she pointed out. 

MA is interested in home health, given recent acquisitions and partnerships between the two, she noted. Home health can position itself to work with MA plans because of its value proposition: it is considered the lowest-cost setting for healthcare, it can manage a mobile workforce and it can lower hospitalization scores.

“We’ve got to get a seat at that table,” Doak said. 

Read Full Article


President's Message

Posted: February 7, 2023

Despite what other groups are offering, PT After Dark is happening at CSM on Thursday, February 23, from 9 PM to 11 PM at the Hilton Bayfront in Aqua DEF. This will be the PT After Dark that we all remember from before the pandemic, with hard topics, hard conversations, and open-minded, welcoming people. I look forward to seeing you there.

Please also join us for our Meet and Greet event on Wednesday, February 22, at 6:30 PM, at the Hilton Bayfront in Aqua 300. Light refreshments will be served. Also, don’t miss our Annual Meeting on Friday, February 24, at 6:30 PM, also at the Hilton Bayfront in Aqua 300. Dinner will be served, and our agenda will include our annual awards and our new strategic plan.


Phil Goldsmith
APTA Home Health


How The Public Health Emergency Helped Cut Regulatory Red Tape For Home Health Agencies

Home Health Care News | By Joyce Famakinwa
With the public health emergency (PHE) set to finally end on May 11, home health stakeholders are finding that the impact won’t be as disruptive as once feared.
This is because most of the biggest issues have already been addressed by Congress and the Centers for Medicare & Medicaid Services (CMS).
“Congress addressed the face-to-face encounter side of it, so we’re not going to be losing as much as we might have, if that hadn’t happened,” Bill Dombi, president of the National Association for Home Care & Hospice (NAHC), told Home Health Care News. “For example, CMS early on in the pandemic made permanent the ability of home health agencies to use virtual visits, if authorized by the treating physician or treating practitioner.”
This means that the required face-to-face encounter for home health services can take place through telehealth.
Another factor that will potentially lessen the negative impact of the PHE ending is the Acute Hospital Care at Home waiver — which was originally tied to the PHE — getting an extension through the omnibus spending bill, Moving Health Home Founder Krista Drobac told HHCN.
“We were successful in decoupling the waiver related to acute care in the home from the PHE at the end of last year when we secured the two-year extension,” she said. “Now we’re focused on educating Congress about the other barriers that didn’t get waived during the PHE but are necessary for providing patients more options in the home.”
Drobac noted that Moving Health Home is pushing for a bill that will potentially be introduced in the House.
“It will give patients the options for care in the home,” she said. “There’s a lot of pieces that are still missing related to home infusion, home dialysis, home-based primary care, home-based imaging, home-based labs and even Medicare personal care services. We’ve taken a look across the full spectrum of all the things that need to change in order for a patient to truly be able to stay home in a variety of different cases, so we’ll be introducing legislation there.”
Still, there are some concerns providers should keep their eye on with the PHE coming to an end in the spring.

Read Full Article

Read the Statment of Administration Policy related to theend of the COVID19 Public Health Emergency and National Emergency


With End of PHE in Sight, Providers Need to Stay Abreast of Waivers, Experts Advise

McKnight’s Home Care | By Liza Berger & Diane Eastabrook

Telehealth. Home care aide training. Hospice volunteer hours. The COVID-19 public health emergency (PHE) initiated waivers for many areas of home health and hospice. As of May 11, according to President Biden this week, the PHE will end, thus summoning the end of many of these flexibilities.
While providers have a little more than three months to plan for the change, LeadingAge President & CEO Katie Smith Sloan said her organization still has questions about how the administration plans to transition to a true post-COVID environment.
“We are actively reaching out to CMS, HUD, and other agencies to better understand what their plans are for the end of the PHE and preparing for how we can best support members,” Sloan said in a statement.
The key now, according to Katie Wehri, director of home Health and hospice regulatory affairs for the National Association for Home Care & Hospice, is for providers to determine the status of the waivers they have been using and act accordingly.
“What they do need to do is to take a look at all of the waivers that they have utilized,” she told McKnight’s Home Care Daily Pulse on Tuesday. “If they are still utilizing any of those waivers they need to determine whether this waiver was made permanent … through legislation or regulatory change. If it was not made permanent, what is the plan for tapering off the use of this waiver?”

Read Full Article


Impending Onset of Medicare Home Health Clawback Payments Gnaws at Providers

McKnight’s Home Care | By Liza Berger
Home health providers have been laser-focused in recent months on the permanent Patient-Driven Groupings Model payment cut — 3.925% — which went into effect on Jan. 1. But there is a looming cut that threatens even more instability for providers: the temporary clawback payments related to PDGM. These reductions, which are expected to total at least $3 billion, may take effect as soon as next year.  
“I can’t say you can rate one as scarier than another,” Bill Dombi, president of the National Association for Home Care & Hospice, said of the permanent and temporary cuts to McKnight’s Home Care Daily Pulse. “In combination, they are a disaster.”
Capstone, a global policy analysis and regulatory due diligence firm, might agree. In a recent policy analysis of “underappreciated developments in healthcare in 2023,” it found that temporary clawbacks in 2024 “represent a potentially larger threat to home health,” than a cut to the market basket.
Other home health leaders have voiced serious concerns about the clawback payments.
“We are very, very concerned about what happens in ’24,”  Joanne Cunningham, CEO of the Partnership for Quality Home Healthcare, told McKnight’s Home Care Daily Pulse. “It’s not a positive picture at all for home health. It’s pretty dire. They are significant reductions to the Medicare home health program. They won’t be implemented without significant harm to patient access.”
It’s not clear yet exactly how much money home health will owe from the temporary cuts related to PDGM overpayments and when. The proposed home health rule, which is due out this summer, will give providers a glimpse of what CMS is planning and how it intends to levy the adjustment, Cunningham said.
“The heat is dialed up now that we are looking at 2024,” she said. “We should see in rulemaking exactly how they are going to extract those [payments], which they didn’t do in 2023.”
The temporary PDGM cuts, like the permanent reductions, are a result of CMS’ overpayments to home health as a result of the transition from the old payment to PDGM in 2020. Home health providers likely owe at least $1 billion each year between 2020 and 2022. Both NAHC and the Partnership disagree with the methodology that CMS used to arrive at the overpayment figures.
This year, both organizations are going to continue to argue this point to members of Congress. They believe they have convinced Congress of their position somewhat, as the recent omnibus bill, which passed into law, required CMS to provide transparency around how it arrives at rate cuts.
Dombi thinks it is unfair to target traditional Medicare home health for cuts as the program helps to subsidize the underpayment from Medicaid and Medicare Advantage. His organization is pushing CMS to suspend all cuts in 2024 until there is a recognition of a need to fundamentally overhaul the payment system.
“We need to create a bridge between today and tomorrow without disruption,” he said.

<< first < Prev 1 2 3 4 5 6 7 8 9 10 Next > last >>

Page 8 of 56