Last week, CMS finalized its proposed rule on the Medicaid face-to-face requirement, which takes effect July 1, 2016. Join VNAA on Feb. 18, 2016 at 12:00 p.m. ET for a conference call with key leadership at the CMS Center for Medicaid and CHIP Services, Division of Benefits and Coverage. They will provide an overview of the final rule and answer VNAA member questions.
The American Journal of Nursing (AJN) has honored the Visiting Nurse Associations of America (VNAA) with two 2015 AJN Book of the Year Awards. The 19th Edition of the VNAA Clinical Procedure Manual, took first place in the Community-Public Health category and the VNAA Manual of Hospice and Palliative Care placed third in the Palliative Care and Hospice category.
Click here to view the new dates on which CMS will hold its webinars for home health agencies (HHAs) in the Value-Based Purchasing (VBP) Model states. Agencies that already registered for these webinars do not need to re-register or provide new information. Note that HHAs in VBP states must register for an EIDM User ID, and submit that EIDM User ID and the agencyâ€™s primary point of contact information to the HHVBP Helpdesk in order to receive the most up to date information about the HHVBP Model. Submitting EIDM User IDs will also allow CMS staff to pre-register HHAs for the Innovation Center Portal. This is necessary in order to access to the HHVBP Secure Data Portal where agencies will find performance reports and submit data for the three New VBP Measures.
The Measures Under Consideration (MUC) list includes all measures under consideration for use in 16 specified Department of Health and Human Services federal health programs, including the Home Health Quality Reporting Program and the Hospice Quality Reporting Program. Measures on the MUC list will be reviewed by the National Quality Forum's Measure Applications Partnership (MAP) and may be selected by CMS for national pay-for-performance and public reporting programs.
CMS has awarded 16 two-year Special Innovation Projects to 10 regional Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs). The overall goal of these projects are to improve the quality of care, including through the reduction in mortality, harm, and health care disparities; reduce costs and provide higher return on investment; link value with quality; and encourage utilization of alternative payment models. CMS selected projects in two categories: (1) â€œInnovations that Advance Local Efforts for Better Care at Lower Cost;â€ and (2) â€œInterventions that are Ripe for Spread and Scalability.â€
While a number of these may be relevant to the work of VNAA members, several programs will specifically target home health or hospice providers.
On Sunday, Nov. 1, more than 250 aging stakeholders joined VNAA in Boston for our Regional Leadership Summit that was held in conjunction with the 2015 LeadingAge Annual Meeting. Bill Simione (Simione Consulting) and Mark Sharp (BKD Consulting) discussed the financial environment for home-based care providers and offered their perspectives on opportunities to reduce costs and increase revenue. Richard Gundling (Healthcare Financial Management Association) discussed the state of partnership, merger and acquisition activity in healthcare broadly and in the home-based care markets more specifically. He addressed what types of partnerships providers are pursuing and how they are evaluating potential partners. Molly Smith (VNAA), Lillian Hummel (Avalere), and Patrick Brown (Penn Home Care and Hospice) discussed home health and hospice payment transformation, focusing specifically on the changes to Medicare reimbursement beginning in Jan. 2016. VNAA looks forward to continuing these important conversations at our 34th Annual Meeting this April 6-8, 2016 in Miami, Fla.
The Quality of Patient Care Star Ratings Preview Reports are now available in your CASPER folders. These reports contain data that will be publicly reported on the Home Health Compare website in January 2016. The deadline to submit a request to have the star rating data suppressed is Oct. 17, 2015. The Preview Reports include directions on how to submit a suppression request if necessary.
More than 100 home health and hospice leaders visited Washington last week to hear from policymakers and to advocate for supportive policies on the Hill at the Visiting Nurse Association of America's 2015 Public Policy Leadership Conference. Reps. Earl Blumenauer (D-OR-3) and David McKinley (R-WV-1) spoke to recent legislative efforts and accepted recognition from VNAA as champions of home-based care. Sen. Pat Roberts (R-KS) also accepted recognition as a 2015 Congressional Champion during a separate meeting at his Senate office.
Last week, MedPAC Commissioners reviewed a plan to develop a "unified" or single approach to paying home health agencies, skilled nursing facilities, inpatient rehab facilities, and long term care hospitals. Congress mandated that MedPAC develop such a methodology based on concerns about the wide variation in costs across post-acute care settings that often treat the same acuity patients. MedPAC has until June 2016 to develop a payment methodology and submit a final report to Congress.
Last week, Peggy Ingraham of the National Foundation to End Senior Hunger (NFESH) wrote this guest blog post highlighting the opportunity and benefits of a pending USDA rule on the SNAP program for VNAA members. Last week, VNAA submitted comments to the USDA in support of the changes that would facilitate nonprofit organizations, including home health and hospice agencies, to establish food purchasing and delivery services for vulnerable patients. Read our full comments here.
This week, VNAA submitted comments to CMS on the mandatory bundled payment program proposed for 75 regions. While in the current proposal home health and hospice agencies are not financial at risk for performance, the CCJR program offers agencies the opportunity to partner with their hospital partners to improve the quality and efficiency of care for joint replacement patients.
Erin M. Denholm has been appointed as the new President and CEO of Trinity Home Health Services (THHS). She replaces Grace McCauley who retired this summer after serving as THHS president and CEO since it was established in 2001. Erin officially joins THHS in early October 2015.
In July, the U.S. Department of Agriculture released a proposed regulation implementing a part of the 2014 Farm Bill that authorizes private nonprofit food purchasing and delivery services to accept Supplemental Nutrition Assistance Program (SNAP) benefits as payment for eligible food items. If this rule is finalized, nonprofit home health and hospice providers, among other eligible organizations, would be able to establish food purchasing and delivery services for SNAP-eligible clients. Patients could use their SNAP benefits to reimburse providers for the cost of food. Providers would have the option of charging clients separately for delivery services. This change will enable home health and hospice agencies to help improve the nutritional and health status of patients, particularly those suffering from chronic and other diseases known to be impacted by diet.
This week, VNAA submitted a request to CMS to resolve two ICD-10 issues facing home health and hospice providers: (1) Potential home health and hospice coding errors due to incorrect physician documentation, and (2) A technical error that may result in initial encounters not being appropriately case-mix adjusted for home health payments. VNAA asks CMS for clear guidance to ensure that home health and hospice organizations transition smoothly to ICD-10.
The national transition to ICD-10 coding begins Oct. 1; but for home health agencies, dual coding starts Aug. 3. VNAA is participating in a workgroup with CMS and other associations to monitor implementation and identify ICD-10 transition issues for home health and hospice agencies.
The Centers for Medicare & Medicaid Services (CMS) has made available free provider-specific comparative data reports for home health agencies (HHAs) nationwide. The Program for Evaluating Payment Patterns Electronic Report (PEPPER) summarizes HHA claims data statistics for areas that may be at risk for improper Medicare payments.
CMS has contracted with Abt Associates to develop and maintain quality measures for the Home Health Quality Reporting Program (HHQRP). As part of the measure development process, Abt is convening a group of stakeholders and experts to provide input and direction. Abt is seeking nominations for participation on the committee.
July 1 marked the beginning of the first 12-month performance period for the new "Quality Assessment Only" (QAO) metric that will be used to assess providers' compliance with the new "Pay-for-Reporting Performance Requirement" established in the CY2015 Home Health Final Rule.
Beginning this July, CMS will begin publishing patient care star ratings and two new NQF-endorsed quality measures as part of Home Health Compare. The star ratings will go live on July 16, 2015 and will be updated on a quarterly basis thereafter.
In order to inform VNAA's comments, we seek input on the impact of the different payment models considered by CMS on your agency. VNAA member Patrick Brown from Penn Home Care and Hospice Services has created this tool to assist members in your analysis. We ask that members use this tool to assess the various models on your agency and share your results with VNAA by emailing Molly Smith at firstname.lastname@example.org. Please note that the model does not include the Severity Add-On (SIA) payment that CMS proposed in the rule. This payment is intended to provide additional reimbursement for hospices that have RNs or social workers provide services to patients in their homes in the last seven days of life. Therefore, your reimbursement may be higher under the CMS model than the tool will currently calculate.
On June 2, CMS held an Open Door Forum to discuss recent changes to the Home Health Quality Reporting Program. This forum discussed Quality Reporting Only: Measure Review and Historic Performance Reports. In essence, performance will be tied to the home health market basket percentage increase annual percentage update (APU) program Ã¢â‚¬â€œ APU can be reduced by two percentage points. The previous HHA performance criterion was deemed inadequate. The Quality Assessment Only (QAO) metric was announced in the CY2015 Home Health Rule and the QAO metric information will be updated in the CY2016 Home Health Rule.
The Visiting Nurse Associations of America is partnering with Intel's Health and Life Science team to gain a comprehensive understanding of home health and hospice providers' use of health IT and telehealth/telemonitoring through a survey of home-based care providers. This survey will take roughly 15 minutes. Please answer to the best of your ability. The first 20 people to respond to the survey in its entirely will receive a $5 gift card to Starbucks.
CMS plans to add Star Ratings for patient experience of care measures (HHCAHPS) to Home Health Compare beginning in January 2016. The stars will be calculated using data from patients who received home health care from July 2014 through June 2015 and will be based on the same data as the HHCAHPS measures publicly reported on the Home Health Compare website.
Strategic partnering in today's healthcare environment will determine the level of success many home health agencies achieve. Significant attention must be focused on payer alliances, growth markets, coordinated clinical hand-offs and readmission reductions. In the midst of strategic planning for the next set of regulatory and reimbursement challenges, it can be difficult to find ways to consistently provide proactive, personalized care.
The House Energy and Commerce Subcommittee on Health will hold a hearing on Thursday, April 16 and will discuss the Bundling and Coordinating Post-Acute Care (BACPAC) Act (H.R. 1458) introduced by Rep. David McKinley (R-WV), Rep. Jerry McNerney (D-CA), and House Budget Committee Chairman Tom Price (R-GA). The hearing is entitled, "Medicare Post-Acute Care Delivery and Options to Improve It."
The Centers for Medicare and Medicaid continues its development of quality measures in home health and hospice. Two VNAA members--Beth Hennessey, RN, BSN, MSN and Danielle Pierotti, RN, PhD, AOCN, CHPN--were recently nominated and have been asked to participate on these newly formed workgroups and committees.
On Tuesday, March 17, the Senate Health, Education, Labor and Pensions (HELP) Committee held a bipartisan hearing on "America's Health IT Transformation: Translating the Promise of Electronic Health Records into Better Care." The hearing examined the role of the Meaningful Use Incentive Program to encourage the use of electronic health records (EHRs), interoperability between EHR systems, and how to further encourage the development of a truly integrated and interoperable health IT system. Many of the Senators who joined the hearing asked the witnesses about the barriers to interoperability. There was discussion regarding how not all providers, like home health providers, are not able to access Meaningful Use payments.
The Institute of Medicine (IOM) and National Research Council (NRC) released the prepublication version of the "The Future of Home Health Care: Workshop Summary." The prepublication version can be downloaded online here (http://bit.ly/1O7bQRR), and the final version will be released in print in the next couple months. The Alliance for Home Health Quality Innovation was a sponsor and driving force that led to this IOM-NRC workshop, which was held on Sept. 30-Oct. 1, 2014. VNAA's President and CEO, Tracey Moorhead spoke at the announcement of this project last year.
On Tuesday, March 10, the Centers for Medicare and Medicaid Services (CMS) announced the "Next Generation Accountable Care Organization (ACO)" model of payment. This new model of ACOs requires participating providers to assume greater risk but offers a number of incentives, including greater opportunity for savings and several waivers that may assist the participating ACOs in managing the care for beneficiaries. Waivers important to VNAA members include the ability for ACOs to be reimbursed for certain home visits after an inpatient stay and expanded use of telemedicine.
VNAA's 33rd Annual Meeting Preconferences off an in-depth look at key issues facing the home-based care industry. A hybrid of educational breakout session and keynote, this year's preconferences are a must attend for leaders in quality, innovation and agency operations.
The current state of health information technology and telehealth applications in home care is complex. At a high level, home care and hospice providers routinely use electronic health records (EHRs) to manage patient care but confront significant challenges related to the interoperability of these records with hospitals and physician provider offices operating in their communities.
The Visiting Nurse Associations of America is partnering with Intel Health and Life Science team to gain a comprehensive understanding of home health and hospice providers' use of health IT and telehealth/telemonitoring through a survey of home-based care providers. This survey will take roughly 15 minutes. Please answer to the best of your ability. The survey will close by 5:00 p.m. ET on Tuesday, March 3, 2015.
On Jan. 29, 2015, CMS announced the extension of temporary moratoria on the enrollment of new ambulance suppliers and home health agencies (HHAs) in specific locations within designated metropolitan areas in Florida, Illinois, Michigan, Texas, Pennsylvania, and New Jersey to prevent and combat fraud, waste, and abuse. The moratoria will be in place for 6 months unless extended by CMS. This is the 4th such extension since CMS initially placed a hold on new home health agencies in two jurisdictions in 2013
Marilyn Tavenner, who oversees the nation's Medicare and Medicaid programs and played a central role in implementing the Affordable Care Act, is stepping down. She announced her departure in an email sent to staff.
This month, Home Health Compare will begin publicly reporting two new measurements: 30-day Readmission of Home Health Patients; and 30-day Use of ED without Hospital Admission.