In the News

Naloxone Availability Where Physical Therapist Services Are Provided HOD P06‐19‐76‐64 [Position]

Posted: September 25, 2019

The American Physical Therapy Association supports physical therapist services having naloxone accessible to be  administered to reverse the effects of an opioid overdose, in accordance with recommendations from the  Surgeon General of the United States.

The House of Delegates' position is available for download here. 

 

TRICARE adopts Medicare’s Home Health Value-Based Purchasing Model as a Demonstration

Posted: September 24, 2019

Today, DoD released a notice of TRICARE’s adoption of Medicare’s Home Health Value-Based Purchasing Model as a Demonstration. This notice describes the adoption of Medicare’s Home Health Value-Based Purchasing (HHVBP) adjustments for reimbursement under TRICARE’s Home Health Prospective Payment System (HH PPS).

This demonstration project will be effective January 1, 2020, through December 31, 2022, unless terminated earlier by Medicare or by TRICARE.
The adoption of this model establishes a new value-based initiative within the TRICARE program, based on Medicare’s similar pilot. In the Medicare HHVBP model, the Centers for Medicare and Medicaid Services (CMS) determines a payment adjustment up to the maximum percentage, upward or downward, based on the Home Health Agency’s (HHA) Total Performance Score (TPS). As a result, the model incentivizes quality improvements and encourages efficiency.

States selected for participation in the Medicare HHVBP model include Arizona, Florida, Iowa, Maryland, Massachusetts, Nebraska, North Carolina, Tennessee, and Washington.  
 CMS cannot release HHVBP adjustment factors to TRICARE, so Home Health Agencies (HHAs) in the participating states will be required to send their annual payment adjustment reports to the applicable TRICARE contractors prior to January 1 each year. Failure to submit the required payment adjustment documentation would result in full application of the negative adjustment factor for the calendar year. This requirement allows TRICARE to mirror Medicare’s HHVBP payment adjustments.  

The TRICARE HHVBP model will only apply to Medicare certified HHAs in the nine participating states.  Specialized HHAs that qualify for corporate services provider status but are not Medicare-certified will continue to be reimbursed under the CHAMPUS Maximum Allowable Charge (CMAC) system and will not be subject to the TRICARE HHVBP model. This demonstration project will assist the Department in evaluating the feasibility of incorporating the HHVBP model in the TRICARE program. TRICARE’s hypothesis is that payments that are linked to quality outcomes will:

(1) Be administratively feasible, meaning that the demonstration will be successfully implemented and administered within a reasonable margin of the DHA’s estimate of this demonstration;
(2) Improve the quality of care delivered over time; and
(3) Be cost-neutral or result in modest long-term cost savings.

Following the end of each 12 months in the demonstration, DHA will measure and report data to the Director, DHA, along with a recommendation of whether to continue or discontinue the demonstration. In the 12 months following termination of the demonstration, DHA shall make a report available to the public on the DHA website which details the findings of this demonstration, and potential next steps, if the demonstration is found to be successful in achieving the anticipated results. Continuation of the demonstration, or a transition into the Basic program reimbursement methodologies will be issued via appropriate Federal Register Notice or rule making action, and will be based on a demonstration that the pilot met the benchmarks set for success that are established in this Notice and Implementing Instructions.

Members, click here to login for more information. You'll find this document under "Home Health General Resources."
 

APTA HHS Attendance at SPPF

Posted: September 24, 2019

Ellen Strunk and Carol Zehnacker from the Government Affairs Committee of the Home Health Section met with Kara Gainer, the APTA Director of Regulatory Affairs, at the State Policy and Payment Forum (SPPF) to discuss PDGM and other issues pertinent to home health. The session began with a presentation of advocacy and how to engage.

 

Now Available: CMS/APTA, AOTA, & ASHA Webinar Recordings and Power Points on PDGM & PDPM

Posted: September 24, 2019

As you may know, APTA, AOTA, and ASHA, together with CMS, recorded webinars with Q&A on PDGM and PDPM. Both webinar recordings and accompanying slide decks are now available on the APTA National website, here.  

The recordings and accompanying slide decks are open to both members and non-members.

 

Resources on the Value of Physical Therapy

Posted: September 24, 2019

The APTA has generated 1 page handouts on the value of physical activity and role of physical therapists. These are tools for therapists to use in helping to communicate their value to patients. They are titled:

  • Reducing the Risk of Falling and Injuries From Falls: Research on the Value of Physical Therapy 
  • Early Mobilization Reduces the Risk of Adverse Events and Improves Function: Research on the Value of Physical Therapy 
  • Preventing Hospital Readmissions: Research on the Value of Physical Therapy 
Members, login to the website to access these 3 handouts. You'll find these 3 documents under "Home Health General Resources."
 
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