Register for the August 4 Hospice Quality Reporting Program Forum

On Wednesday, August 4th, the Centers for Medicare & Medicaid Services (CMS) will host a webinar to share updates on the on the fiscal year (FY) 2022 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Requirements Final Rule.

During this webinar, a CMS subject matter expert will provide information on the following topics:

• · FY 2022 Hospice Final Rule summary
• · Public display of quality measures and other hospice data updates

CMS will answer questions at the end of the webinar, as time permits.

Webinar Details

Title: CMS Hospice Quality Reporting Program Forum – 2022 Rulemaking Update

Date: Wednesday, August 4, 2021

Time: 2:00 - 3:00 p.m. ET

Registration Link: https://register.gotowebinar.com/register/7879279960570652687

Pfizer says immunity can drop to 84% within four months in people who got its COVID-19 shot, further bolstering the company case for a booster

Market Watch/ By Jaimy Lee

The drug maker said this week that new data shows effectiveness can decline to about 83.7% four to six months after vaccination

The effectiveness of Pfizer’s COVID-19 shot can drop to 83.7% within four to six months after getting the second dose of its vaccine. This is the latest indication that vaccine-induced immunity to the virus can wane and some kind of boost may be necessary in the future.

New research published Wednesday as a preprint indicates that the Pfizer Inc.  shot provides 96.2% protection for the first two months, 90.1% effectiveness between the second and fourth months, and between 83.7% of protection for the fourth, fifth, and six months. 

“We will need a booster eight to 12 months from the second dose,” Pfizer CEO Albert Bourla said Wednesday, according to a FactSet transcript of the company’s second-quarter earnings call. 

The drug maker has been making the case for booster shots, citing limited data from its own clinical research and real-world data out of Israel, where Pfizer’s vaccine is the predominant shot in circulation.  “We do see—after six to eight months—more rapid waning concerning infections and mild to moderate symptoms,” Dr. Mikhail Dolsten, Pfizer’s chief scientific officer, said during the call. “Those are likely entirely, or to a large degree, dependent on antibodies and the drop in titer that we alluded to. If you raise it, you may have a good probability to reverse that waning.”

Still, there’s no simple black-and-white answer to whether booster shots are needed at this time. One, there is no definitive data. The new Pfizer data is the most detailed so far, though the company plans to submit clinical data for a third dose to the Food and Drug Administration in early August.

Read Full Article

https://www.marketwatch.com/amp/story/pfizer-says-immunity-drops-to-83-within-six-months-in-people-who-got-its-covid-19-shot-further-bolstering-the-company-case-for-a-booster-11627579817

Dying MA customers are switching to traditional Medicare

Modern Healthcare / Michael Brady
 
Medicare Advantage beneficiaries can't access the care they need as they get sicker, a new report from federal watchdogs suggests.
 
People enrolled in Medicare Advantage plans are switching to Medicare fee-for-service at an alarming rate during their last year of life, according to a Government Accountability Office (GAO) report published Wednesday. Medicare Advantage customers in their last year of life were more than twice as likely to drop their policies and enroll in Medicare fee-for-service than other Medicare Advantage enrollees.
 
"Among other reasons, beneficiaries in the last of year life may disenroll because of potential limitations accessing specialized care under MA," the GAO concluded.
 
In 2017, 5% of Advantage beneficiaries in their last year of life converted to traditional Medicare, compared to 2% of all other enrollees, the oversight agency reported.
 
Medicare Advantage has grown popular over decades as beneficiaries opt for insurance policies that come with extra benefits not available in traditional Medicare. But given their nature as private insurance products with limitations such as provider networks and varying benefit designs, Medicare Advantage has always drawn skeptical appraisals from those concerned about access to care.
 
"Beneficiaries in their last year of life are generally high-cost and disproportionately require specialized care, with a few studies estimating that they may account for as much as a fifth to a quarter of all [fee-for-service] spending," the GAO found. The federal government would have saved $912 million during 2016 and 2017 had fewer Medicare Advantage enrollees opted into traditional Medicare during their last year of life, the GAO estimates.
 
The watchdog recommends CMS review disenrollment by Medicare Advantage customers in their last year of life as part of the agency's broader analysis of Medicare Advantage beneficiaries in poor health who switch to fee-for-service Medicare. The agency began that evaluation after the GAO reported in 2017 that sicker beneficiaries are more likely to drop out of Medicare Advantage.
 
"Given their high costs and specialized care needs, a specific focus on disenrollments by beneficiaries in their last year of life could help CMS better identify and address potential concerns regarding their care under MA, and ensure efficient Medicare program spending," the GAO report say.
 
HHS agreed with GAO's recommendation.

Access to Patients in Nursing Homes

In recent days, NHPCO has been hearing some renewed concerns about hospice providers’ access to patients in nursing homes and would like to make CMS aware of this issue. Please email [email protected] to let us know about any recent experiences you have had accessing and providing care for patients in these settings. These could include access to patients, inability to do in-person assessment visits, and any other requirements from nursing homes for hospice patients residing there.