In The News

Free Web-Based COVID-19 Safety Training for Direct Care Workers

With funding from the Occupational Safety and Health Administration (OSHA), The University of Southern Maine’s Cutler Institute has developed a no-cost, web-based COVID-19 safety training for direct care workers. The training focuses on the safety of the worker and covers the Centers for Disease Control and Prevention’s recommendations for stopping the spread of coronavirus in home and community-based settings. 

The training is:

  • Free and easy to use.
  • Accessible via computer, tablet, or smartphone.
  • Approximately 90 minutes in length. Start and stop at your convenience and pick-up where you left off!
  • Focused on specific risks of COVID-19 in direct care settings and ways to keep safe.
The training is available at COVID-19 Workforce Protection Training (covidinfectionprevention.org)
 

NHPCO's Banach: A Community-Based Palliative Benefit May Come in 2021

Hospice News/By Jim Parker

A community-based palliative care benefit may emerge from the U.S. Centers for Medicare & Medicaid Services during 2021, according to National Hospice & Palliative Care Organization (NHPCO) President and CEO Edo Banach. Though nothing is certain, Banach told Hospice News that factors exist that make it more likely to occur, including the COVID-19 pandemic.

Currently Medicare reimburses for palliative care physician services through fee-for-service payment programs that do not sufficiently cover the full range of interdisciplinary care, but calls grew louder among health care stakeholders and policymakers during the pandemic for Medicare to establish a dedicated community-based palliative care benefit.

“We’re incredibly hopeful that this is the year, after decades of talking about it, that we’re actually going to get a benefit that we can wrap our arms around,” said Banach during the opening keynote of NHPCO’s Leadership & Advocacy Conference . . . 

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HOSPICE AGGREGATE PAYMENT LIMITATION (“CAP”) INCREASINGLY REDUCING MEDICARE HOSPICE PAYMENTS

Hospice News/Volume 21.03

The Medicare Payment and Advisory Commission (“MedPAC”) recently recommended that “For fiscal year 2022, the Congress should eliminate the update to the 2021 Medicare base payment rates for hospice and wage adjust and reduce the hospice aggregate cap by 20 percent.”

Our exposure to hundreds of hospices annually clearly indicates that the number of hospices exceeding the CAP continues to grow. According to MedPAC, “In 2018, about 16 percent of hospices exceeded their CAP.” We expect the number of hospices exceeding the CAP for the 2018 CAP Year to exceed MedPAC’s estimate of 16%. Even so, it is apparent that MedPAC is encouraging the government to use the CAP as a means for penalizing hospices that are reporting, in their opinion, excessive Medicare margins (payments over costs) created primarily because of long episodes of care. Based on the MedPAC report, the following summarizes hospice episodes of care by length:

Episodes 5 days or less 25%
Episodes of 6-18 days 25%
Episodes of 19-85 days 25%
Episodes of 86-265 days 15%
Episodes of 266 days or more 10%

MedPAC estimates that the modification to the CAP would cause 28% of hospices to exceed the CAP, thereby generating a 3.2% reduction in Medicare payments, assuming no changes in utilization. While such a change would generally affect hospices with higher margins, before repayment of the CAP liability, the change would also significantly impact many rural providers unable to survive payment reductions that would result.

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Congress Extends Medicare Sequestration Relief

Thanks in large part to our collective advocacy, the Senate has passed H.R. 1868, which would extend the moratorium on the 2% Medicare sequestration until December 31, 2021. To offset the cost, the bill also extends the timeframe for the Medicare sequestration to permanently expire to the end of 2030.

President Biden is expected to sign the legislation into law after the House passes the Senate version of the bill. However, the House is not scheduled to be back in session to vote on legislation until April 13, 2021, after the current moratorium has expired on March 31, 2021. Negotiations regarding the lapse beginning April 1st are ongoing.

 

Five Reasons Why COVID Herd Immunity is Probably Impossible

Nature.com/ By Christie Aschwanden

As COVID-19 vaccination rates pick up around the world, people have reasonably begun to ask: how much longer will this pandemic last? It’s an issue surrounded with uncertainties. But the once-popular idea that enough people will eventually gain immunity to SARS-CoV-2 to block most transmission — a ‘herd-immunity threshold’ — is starting to look unlikely.

That threshold is generally achievable only with high vaccination rates, and many scientists had thought that once people started being immunized en masse, herd immunity would permit society to return to normal. Most estimates had placed the threshold at 60–70% of the population gaining immunity, either through vaccinations or past exposure to the virus. But as the pandemic enters its second year, the thinking has begun to shift. In February, independent data scientist Youyang Gu changed the name of his popular COVID-19 forecasting model from ‘Path to Herd Immunity’ to ‘Path to Normality’. He said that reaching a herd-immunity threshold was looking unlikely because of factors such as vaccine hesitancy, the emergence of new variants and the delayed arrival of vaccinations for children.

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