In The News

Hospital At Home Is Not Just For Hospitals

Health Affairs | By Pamela Pelizzari, Bruce Pyenson, Anna Loengard, Matthew Emery
 
Hospital at Home programs deliver needed services to appropriate patients in their homes and can effectively serve patients, payers, and providers. The programs provide physician visits, drugs, monitoring, nursing services, diagnostics, and other services at a level typically reserved for patients in inpatient settings. A typical Hospital at Home patient has features that make home care preferable, for example, they may present to an emergency department with uncomplicated, simple pneumonia, have no significant comorbidities, and live with a partner who can provide basic care, such as preparing meals. Studies have shown these programs have lower readmission rates, lower payer costs, and higher patient satisfaction. Patients prefer their homes, payers prefer having patients get care in the least acute setting possible, and hospital providers want to have beds available for patients who need them.
 
While Hospital at Home programs have been studied since the 1970s, adoption had been slow until the COVID-19 public health emergency (PHE) prompted the Centers for Medicare and Medicaid Services (CMS) to waive the Medicare Hospital Conditions of Participation to enable the use of this care delivery model for Medicare beneficiaries. In 2020, CMS implemented the Acute Hospital Care at Home Waiver, which establishes Medicare payment for home hospitalizations. The combination of the PHE and CMS’s regulatory response has generated huge demand for Hospital at Home. By July 2021, eight months after the Acute Hospital Care at Home Waiver program was established, more than 140 hospitals across 66 health systems were approved by CMS to provide hospital services in a home setting. Because of COVID-19, patients and providers have quickly embraced telehealth, and that “stay at home” attitude may bring Hospital at Home into the mainstream. In 2019, the Medicare population had more than 800,000 hospitalizations, which could have qualified for Hospital at Home. As the care delivery model grows in the post-PHE, some important questions remain, such as how insurers will reimburse providers for Hospital at Home services and the types of provider organizations that will embrace this novel care delivery model.
 
Top-Down And Bottom-Up Payment Approaches
 
Medicare currently pays for Hospital at Home using a top-down (hospital-centered) payment—the payment is made to hospitals, and the amount is based on Medicare’s payment system for acute inpatient admissions. An alternative, bottom-up approach could generate a payment amount on the basis of existing home-based care payment systems, with additions for the expanded services needed for the more acute patients in a Hospital at Home model. Because home care providers are typically reimbursed at lower rates, this approach to payment would be less expensive and could capitalize on the existing in-home care expertise these providers have, while expanding their reach to a higher-acuity patient population. The co-authors have compared payment options for home hospitalization programs under both the top-down and bottom-up approaches.

Read Full Article
 

CMS Updates Guidance Related to Emergency Preparedness R/T the Ongoing PHE

From CHAP

CMS’s Quality, Safety & Oversight Group posted Revised Memo on May 26, 2022, which provides updated guidance for surveyors and providers about emergency preparedness training and testing program exemptions and assessment of compliance with the EP requirements. (Guidance related to Emergency Preparedness- Exercise Exemption based on A Facility's Activation of their Emergency Plan (Ref: QSO-20-41-ALL, Revised 5/26/2022))

This updated guidance only applies if a facility/provider is still currently operating under its activated emergency plan or reactivated its emergency plan for COVID-19 in 2021 or 2022.

If your organization has resumed normal operating status (not under their activated emergency plans), you are required to conduct testing exercises based on the regulatory requirements for their specific provider or supplier type. 

Background: The emergency preparedness regulations allow an exemption for providers or suppliers that experience a natural or man-made event requiring activation of their emergency plan. On Friday, March 13, 2020, the President declared a national emergency due to COVID-19 and subsequently many providers and suppliers have activated their emergency plans to address surge and coordinate response activities. Facilities that activate their emergency plans are exempt from the next required full-scale community-based or individual, facility-based functional exercise. Facilities must be able to demonstrate, through written documentation, that they activated their program due to the emergency.

Updated guidance key points:

  • CMS recognizes many facilities are still operating under disaster/emergency conditions during the PHE, (e.g., under an activated emergency plan), so they are providing additional guidance for inpatient and outpatient providers/suppliers, consistent with the exemption authorized by the EP regulations. 
  • This guidance provides clarifications on testing exemptions for those providers/suppliers who continue to operate under their activated emergency plan and those which may have reactivated their emergency plans for COVID-19. 
  • This exemption applies to the next required full-scale exercise only, not the exercise of choice, based on the facility's 12-month exercise cycle. 
    • The exercise cycle is determined by the facility (e.g., calendar year, fiscal year or another 12-month timeframe).

This guidance will also apply for any subsequent 12-month cycles in the future, in the event facilities continue to operate under their activated emergency plans for COVID-19 response activities.
 

Monkeypox Virus Infection in the United States and Other Non-endemic Countries—2022

Cases of monkeypox have previously been identified in travelers from, or residents of, West African or Central African countries where monkeypox is considered to be endemic. CDC is issuing this Health Alert Network (HAN) Health Advisory to ask clinicians in the United States to be vigilant to the characteristic rash associated with monkeypox. Suspicion for monkeypox should be heightened if the rash occurs in people who 1) traveled to countries with recently confirmed cases of monkeypox, 2) report having had contact with a person or people who have a similar appearing rash or received a diagnosis of confirmed or suspected monkeypox, or 3) is a man who regularly has close or intimate in-person contact with other men, including those met through an online website, digital application (“app”), or at a bar or party. Lesions may be disseminated or located on the genital or perianal area alone. Some patients may present with proctitis, and their illness could be clinically confused with a sexually transmitted infection (STI) like syphilis or herpes, or with varicella zoster virus infection. Read the full report at Monkeypox Virus Infection in the United States. 

Additional information on Monkeypox can be found here: Monkeypox | Poxvirus | CDC 
 

COVID-19 Booster Now Available for Children Aged 5-11 Years

The U.S. Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) recently authorized and endorsed a single booster dose of the Pfizer-BioNTech COVID-19 vaccine for children aged 5-11 years at least five months after completion of a Pfizer-BioNTech COVID-19 vaccine primary series. The Centers for Medicare & Medicaid Services (CMS) will continue to ensure that coverage is available for this critical protection from the virus that causes COVID-19, including this new booster dose, without cost sharing.

The best way to protect yourself and your children from COVID-19 is to get vaccinated. Parents, if you have not gotten vaccinated, or have not taken your children to get vaccinated, now is the time. Continued safety monitoring shows that the COVID-19 vaccines are safe for children and teens. In addition, they are effective at preventing severe illness from infection with the virus.

CMS is helping to ensure that cost is not a barrier to access, including for boosters. The federal government is providing vaccines free of charge to everyone 5 years and older living in the United States, regardless of their immigration or health insurance status. People can visit vaccines.gov (English) or vacunas.gov (Spanish) to search for vaccines nearby.

CMS continues to explore ways to ensure maximum access to COVID-19 vaccinations and boosters. There are numerous resources available. Organizations can use the free, customizable materials from the web available through this web page CMS COVID-19 web page. This important information can be utilized in their outreach efforts year-round, including digital videos, palm cards, posters, infographics, social media messages, graphics, and more.

Please share these materials, bookmark these pages, and check back often for the most up-to-date information. It is important to us that we help encourage our beneficiaries and consumers –especially those with chronic conditions – to protect themselves and their loved ones from COVID-19.
 

National Healthcare at Home Best Practices and Future Insights Study

The Home Care and Hospice Association of Colorado (HHAC) is pleased to share the results of the National Healthcare at Home Best Practices and Future Insights Study.

With over 1,000 agency sites represented, we ended up with the largest and most comprehensive study in the history of home care and hospice to date.  And now members can access the complimentary study report.

Download the report to gain perspective on best practices for:

  • Operational, clinical, and financial processes
  • Staffing recruitment and retention
  • Technology
  • Palliative Care
  • And much more!

The National Healthcare at Home Best Practices Study is sponsored by the Home Care and Hospice Association of Colorado, National Association for Home Care and Hospice (NAHC),  National Hospice and Palliative Care Organization (NHPCO), NAHC Forum of State Associations, LeadingAge, Home Care Association of America (HCAOA), and Council of State Home Care Associations.   The study was conducted by BerryDunn, a national healthcare at home consulting, research, and audit firm with over 25 year experience in home health and hospice.
 
More Articles...
<< first < Prev 211 212 213 214 215 216 217 218 219 220 Next > last >>

Page 216 of 377