In The News

ATTENTION Hospices! CMS Recruiting Additional Hospices for HOPE Beta Testing

As hospices should already be aware, the Centers for Medicare & Medicaid Services (CMS) and Abt Associates are currently beta testing a draft standardized hospice patient assessment instrument called Hospice Outcomes & Patient Evaluation (HOPE).  Additional hospice providers are needed to complete the testing.

Hospices must be Medicare-certified and training for this round of hospices is anticipated to occur mid-July 2022 with data collection slated to begin in August 2022 and continue through early fall 2022.

CMS is specifically seeking hospice providers with sufficient registered nurse, social worker, and chaplain staffing to conduct at least 1 – 2 joint visits per week. Hospices currently participating in the beta test may be finding this difficult amidst the workforce shortage causing CMS to recruit more hospices.

It appears that CMS is still aiming for completion of the beta testing in early fall of this year.  Should this occur, there may be time for CMS to analyze the results of the testing and formulate a proposal for use of the HOPE by all hospices in the FY2024 proposed rule.  This proposed rule would be posted in Spring 2023 for public review.

Joint visits are typical in beta testing standardized assessment instruments such as the HOPE for inter-rater reliability, but it is not expected that joint visits will be required when a HOPE tool is implemented in hospice. CMS includes the following additional information about the 1-2 joint visits per week that would occur as part of the HOPE testing:  For joint visits, two registered nurses visit one patient at the same time to complete the HOPE nurse assessment. Two social workers visit the patient at the same time to complete the HOPE social work assessment, and two chaplains visit the patient at the same time to complete the HOPE chaplain assessment. One of the two registered nurses, social workers and chaplains may attend their joint visit via video call, such as Zoom. HOPE assessments are completed at hospice admission, for symptom reassessment and at live discharge.

Recruitment will continue until CMS reaches the desired number of participants (number not specified). Those interested in participating should email [email protected] by June 30, 2022.

 

Support for Family Caregivers

For caregivers, the job doesn’t end at 5pm. You don’t get time off on weekends. Your around-the-clock dedication to your care partner likely means you need support to face the challenges each new day may bring. The Building Better Caregivers® (BBC) six-week online workshop, developed by Stanford University, can help you reset, recharge and discover new information so you can be the best caregiver you can be. When you join a BBC workshop, you’ll connect with a small group of caregivers just like you and support each other in reaching your goals.

“The workshop helped me see different ways to approach my caregiving responsibilities. I tried to learn to re-channel some feelings or rethink my feelings in a more positive way. And I didn’t feel guilty for taking time for me. There were helpful tools & ideas, and also, reading the feedback was helpful & positive for me. With each week it gave me another chance at becoming a better caregiver. Thank you for this workshop!”  - BBC Graduate

Click here to join a BBC workshop and you’ll learn:

  • New ways to approach caregiving
  • How to reduce stress and find guilt-free time for yourself
  • Tools to help you manage your time and improve your relationship with your care partner

To participate in BBC, caregivers must be enrolled in one of the Department of Veterans Affairs’ Caregiver Support Program offerings:

If you are a caregiver, reach out to your Caregiver Support Team to learn more about signing up or visit BBC’s website today!

 

Home Health Value-Based Purchasing Model

First Five Performance Years (2016-2020) Evaluation Report - Key Takeaways: 

The Home Health Value‐Based Purchasing (HHVBP) Model provides financial incentives to home health agencies for quality improvement based on their performance relative to other agencies in their state. The first five years of the implementation of the original HHVBP Model have resulted in cumulative Medicare savings of $949.2 million, a 1.6% decline relative to the 41 non-HHVBP states, as well as improvements in quality. These impacts were observed during 2020, the third year for quality-based payment adjustments, as well as the first four years of the model.

The Two Page Overview:

The Report (includes an Executive Summary):

Additional Supporting Materials:

Model Page: Home Health Value-Based Purchasing Model

 

CDC and FDA Clear the Way for COVID Vaccines for Kids Under 5

CBS News / By Alexander Tin

Some 20 million babies, toddlers, and preschoolers are now eligible to be vaccinated for COVID-19, after the Centers for Disease Control and Prevention's Director Dr. Rochelle Walensky signed off on unanimous votes from her agency's outside vaccine advisers to recommend shots from Moderna as well as Pfizer and BioNTech for children as young as six months old.

"Together, with science leading the charge, we have taken another important step forward in our nation's fight against COVID-19," Walensky said in a statement.

Around a third of parents say they plan to get their child in the age group vaccinated, according to CDC survey findings released on Saturday. Some of the long-awaited shots could begin as soon as this holiday weekend. Federal officials expect the bulk of vaccinations will commence after doctor's offices reopen on Tuesday.  

"We know millions of parents and caregivers are eager to get their young children vaccinated, and with today's decision, they can. I encourage parents and caregivers with questions to talk to their doctor, nurse, or local pharmacist to learn more about the benefits of vaccinations and the importance of protecting their children by getting them vaccinated," added Walensky.

The CDC's Advisory Committee on Immunization Practices voted following a two day-long meeting to mull data on the benefits and risks of the shots in young children. A panel of the Food and Drug Administration's own outside advisers had also voted unanimously on Wednesday to back authorization.

"Those trusted with the care of children can have confidence in the safety and effectiveness of these COVID-19 vaccines and can be assured that the agency was thorough in its evaluation of the data," FDA Commissioner Dr. Robert Califf said in a statement.

The FDA also moved on Friday to add Moderna's vaccine as an alternative to Pfizer's shots in children 6 through 17 years old, though the CDC said their advisers will not vote on updated recommendations for those shots until next week. 

Read Full Article 

 

‘The Stability of Home Health Care Is at Risk’: CMS Proposes 4.2% Decrease to Provider Payments in 2023

The U.S. Centers for Medicare & Medicaid Services (CMS) released its FY 2023 home health proposed payment rule late Friday.

It comes with a decrease to payment rates by 4.2%, or $810 million less compared to 2022 rates. Overall, the proposed rule looks to be one that will be disappointing to providers, and one they will refute heavily in the public comment period.

“This decrease reflects the effects of the proposed 2.9% home health payment update percentage ($560 million increase), an estimated 6.9% decrease that reflects the effects of the proposed prospective, permanent behavioral assumption adjustment of -7.69% ($1.33 billion decrease), and an estimated 0.2% decrease that reflects the effects of a proposed update to the fixed-dollar loss ratio used in determining outlier payments ($40 million decrease),” CMS wrote in its fact sheet.

The proposed rule validated concerns that providers have had since the hospice proposed rule and skilled-nursing-facility proposed rules came out earlier this year.

“We are very disappointed in the CMS proposed rule issued today,” William A. Dombi, the president of the National Association for Home Care & Hospice (NAHC), wrote in a comment shared with Home Health Care News. “The stability of home health care is at risk as a consequence of CMS proposing the application a fatally flawed methodology for assessing whether the PDGM payment model led to budget neutral spending in 2020. That has been made clear to CMS in the 2021 rulemaking and in multiple discussions since.”

They will likely argue that the proposal clearly does not take into account multiple factors currently hindering providers, including: raised labor costs, a severely high inflation rate and other ongoing heightened expenses related to COVID-19.

“With significantly rising costs for staff, transportation, and more, home health agencies across the country cannot withstand the impact of the proposed rate cut,” Dombi added. “Reliable analyses proves that PDGM underpaid home health agencies. We will be taking all steps to protect the home health benefit as this proposed rule advances and have fully prepared for Congressional action and more. “

On the hospice side, CMS recently proposed a 2.7% pay increase for 2023. Meanwhile, SNF operators saw a proposed downward adjustment to SNF payment rates by 4.6%.

The latter rate adjustment is partly to balance out the Patient-Driven Payment Model (PDPM), which is similar to the home health industry, in that adjustments are being made to the Patient-Driven Groupings Model (PDGM).

In that vein, CMS is proposing to apply a permanent prospective payment adjustment to the home health 30-day period payment rate. That would be to account for any increases or decreases in aggregate expenditures as a result of the “difference between assumed behavior changes and actual behavior changes,” due to the implementation of the PDGM and 30-day unit of payment.

The full fact sheet from CMS can be viewed here.

 
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