Request for Info on Providers that Deliver Palliative Care

The Center for Medicare and Medicaid Innovation (CMMI) is looking for a rough estimate of the service footprint of palliative care providers across the country. Given the lack of a formal and specific Medicare provider type for “palliative care”, they cannot simply use internal enrollment data to ascertain palliative care’s reach.  To that end, they are inquiring with various organizations for any information or data they can share on their members’ palliative care footprint.

NAHC is requesting any information from state associations that have data or even rough estimates on the number of your members providing palliative care and/or the zip codes or counties in which they offer these service. Please send your information directly to HHAC at [email protected]

 

MedPAC: Majority of Medicare Beneficiaries to be on MA by 2023, but Coding Issues Remain Rampant

Fierce Healthcare | Jan 14, 2022 5:05pm
 
Most Medicare beneficiaries in Parts A and B are expected to be enrolled in Medicare Advantage plans by next year, but spending on the plans is going to continue to outpace traditional fee-for-service, a congressional advisory panel found.
 
The Medicare Payment Advisory Commission (MedPAC), a panel that makes recommendations to Congress on Medicare policy, released new findings Friday on the program, which has surged in popularity in recent years. It also continues to raise alarms over practices plans have done such as upcoding that have increased Medicare spending.
 
MedPAC found 46% of beneficiaries in Parts A and B were enrolled in MA plans, and that figure is expected to stretch past 50% in 2023.
 
“Despite a decrease in MA rates, the MA enrollment has continued to grow rapidly,” said Luis Serna, a MedPAC staff member, during the panel’s meeting Friday.
 
The panel also found that for this year, 99% of Medicare beneficiaries have access to at least one plan, and 98% of them can choose a plan with a Part D benefit.
 
But MedPAC found that the explosion of growth has not also led to more savings for traditional Medicare.
 
The panel discovered that this year spending in MA will be 4% higher than fee-for-service Medicare after considering coding practices such as upcoding, which leads to higher quality bonuses for plans.
 
"MA plans have a financial incentive to document more diagnoses than providers in fee-for-service Medicare, leading to larger MA risk scores and greater Medicare spending on the beneficiary that enrolls in MA,” said staff member Andy Johnson, Ph.D.
 
In 2020, MedPAC found MA risk scores were 9.5% higher than fee-for-service beneficiaries that had a similar health status.

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OASIS-E Update

CMS has released the 1st quarter 2022 OASIS FAQs. The FAQs include several questions and answers regarding OASIS-E. The document states that OASIS-E data collection will begin with OASIS assessments with a M0090 date on  or after January 1, 2023. CMS will release a draft of the updated version of the OASIS instrument, OASIS-E, in early 2022, though we don’t yet have a more specific date.

The updated draft dataset and the final OASIS-E dataset will be posted on the Home Health Quality Reporting Program OASIS Data Sets webpage (when available, date TBD) https://www.cms.gov/Medicare/Quality-Initiatives-Patient-AssessmentInstruments/HomeHealthQualityInits/OASIS-Data-Sets
 

Don’t Miss Your Opportunity to Participate in the Largest Healthcare at Home Study to Date

HHAC has partnered with the leaders of the National Healthcare at Home Best Practices Study to deliver best practices and insights on the future of home care delivery to our members. The study is now in its final stages and we need to ensure Colorado is represented.  Agencies who have not yet participated in the full study are asked to complete 25 key questions to ensure all agency demographics are represented.  Click here to complete the survey and make sure your voice is heard.  

Some exciting preliminary insights from the study to date include:

  • Not measuring or knowing your staff turnover rate can lead to one full patient satisfaction STAR rating below agencies that do.  
  • Hospices with palliative care programs show an increased median length of stay from 19 days to 26 days while maintaining a healthy average length of stay of 72 days.  
  • Pay was listed as the number one reason for staff turnover in both home health and hospice surveys, followed by home care and COVID related burnout.  In addition, agencies that offered a variety of bonuses had lower overall turnover rates.

Participating agencies receive exclusive access to an interactive portal with detailed benchmarks that can be segmented by size, outcomes, and more.  But we can’t include all breakdowns, including by state, unless we receive your help.  Join hundreds of other thousand agency sites who have completed the National Best Practice Study survey today and get access to ALL insights released from the study.

The National Healthcare at Home Best Practices Study is sponsored by HHAC,  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.   Agencies can learn more about the study at the study website or by emailing [email protected]
 

State Reverses Course, Puts Moratorium on CNA PAR Denials and Reductions

A mysteriously high number of PAR (Prior Authorization Request) disapprovals have been coming from state Medicaid's new utilization manager, KEPRO, with many of our home health agency members and their client families being negatively affected. 

Last week, following extensive lobbying efforts by HHAC, we received word through State Rep. Susan Lontine that the state has reversed course and will stop CNA PAR Denials and Reductions until June 1. Additionally, the state will reinstate benefits back to Nov. 1, 2021. 

HHAC intends to share more information with you in the coming weeks about our efforts to fix ALL of the issues surrounding PAR approvals and disapprovals. In the meantime, thank you for your membership in HHAC. Your support of our association makes it possible for our association to fight these battles on behalf of all home care agencies and hospice organizations.
 
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