In The News

Home Health Referral Trends That are Significant for the Industry in 2023 and Beyond

Home Health Care News | By Andrew Donlan

Home health referrals are well above where they were before the pandemic, but not necessarily at the expense of skilled nursing facilities (SNFs). 

There are now more patients in need of home health services, and those patients tend to be sicker. At the same time, agencies are struggling to meet demand in a tough recruiting and retention environment. 

Those takeaways and others are according to new data reporting from CarePort. 

Specifically, home health referral volumes have reached 122% of 2019 levels. At the same time, SNFs have reached 104% of their referral volume. That is as of this past October. 

“In relative terms, there just continues to be a gap between home health and SNFs, and I expect that gap to continue to widen, because I think COVID led a change in patient preference in terms of going home,” Lissy Hu, president of connected networks at CarePort, told Home Health Care News. “And the response to that by the health systems and payers – because it’s a higher value setting and a lower cost setting of care – is that payers and providers are putting more technology and systems in place to accommodate those patients who can be in the home.”

CarePort – a part of WellSky – is a care coordination software platform. It helps health systems and hospitals connect with post-acute care providers, such as home health agencies.

While increasing home health referrals are mostly welcomed news for providers in the space, more referrals does not exactly mean more business and more bottom-line revenue. 

As the referral rates have been rising, referral rejection rates have also been climbing. In January, for instance, the home health industry’s rejection rate was 58%, according to CarePort. That was at least 16% higher than pre-pandemic levels. 

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Explainer: What do we Know About COVID Variant XBB.1.5?

Reuters: By Gabrielle Tétrault-Farber and Jennifer Rigby

The Omicron subvariant, XBB.1.5, is causing concern among scientists after its rapid spread in the United States in December.

Here is what we know so far:

WHAT IS THE XBB.1.5 SUBVARIANT AND HOW DOES IT BEHAVE?

The World Health Organization's senior epidemiologist Maria Van Kerkhove said XBB.1.5 is the most transmissible Omicron sub-variant that has been detected so far. It spreads rapidly because of the mutations it contains, allowing it to adhere to cells and replicate easily.

"Our concern is how transmissible it is," Van Kerkhove said in a news briefing on Wednesday.

XBB and XBB.1.5 were estimated to account for 44.1% of COVID-19 cases in the United States in the week of Dec. 31, up from 25.9% in the previous week, according to data from the U.S. Centers for Disease Control and Prevention. It has also been detected in 28 other countries worldwide, the WHO said.

XBB.1.5 is yet another descendant of Omicron, the most contagious variant of the virus causing COVID-19 that is now globally dominant. It is an offshoot of XBB, first detected in October, which is itself a recombinant of two other Omicron sub-variants.

HOW DANGEROUS IS XBB.1.5?

The WHO said it does not have any data on severity yet, or a clinical picture on its impact. It said that it saw no indication that its severity had changed but that increased transmissibility is always a concern.

"We do expect further waves of infection around the world, but that doesn't have to translate into further waves of death because our countermeasures continue to work," said Van Kerkhove, referring to vaccines and treatments.

She said the WHO was unable to currently attribute the increase in hospitalizations in the northeastern United States to the variant, given that many other respiratory viruses were also in circulation.

Virologists agree that the emergence of the new subvariant does not mean there is a new crisis in the pandemic. New variants are to be expected as the virus continues to spread.

XBB.1.5 is likely to spread globally, but it remains unclear if it will cause its own wave of infections around the world. Current vaccines continue to protect against severe symptoms, hospitalisation and death, the experts say.

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2023 Preliminary VA Reimbursement Rates Released

The U.S. Department of Veterans Affairs has released the preliminary 2023 Fee Schedule for the Community Care Network. The rates on the schedule will not be effective until February 1, 2023. The current fee schedule will remain in effect until then. This schedule includes reimbursement rates for home care services.

CLICK HERE to view the 2023 preliminary fee schedule.

CLICK HERE to access HCAOA member Paradigm Senior Services’ helpful rate finder tool.

Please let Eric Reinarman, Esq. know no later than Wednesday, January 11 if a rate in your area experienced a detrimental decrease. The HCAOA VA Advisory Council will request the VA leadership to reconsider the reimbursement amount. Please provide a rationale for any additional amount needed in that market.

Understand that the VA is not obligated to make any adjustments to the preliminary schedule. You can email Mr. Reinarman at [email protected].

 

IRS Updates Gas Mileage Rate

The IRS announced updated rates for gas mileage reimbursement for 2023. Starting January 1, 2023, the standard mileage rate for business travel is 65.5 cents per mile, a 3 cents per mile update from the July 2022 update.

The reimbursement rate for medical or moving purposes was kept at 22 cents per mile, and the rate for charitable organizations also remained unchanged at 14 cents per mile.

With the continued increase in costs associated with vehicles, agencies must set their own policy regarding reimbursement to employees utilizing their own vehicle.

 

Telehealth G-Codes

The Health Group 

Prior to January 1, 2023, data on telecommunications technology used during a 30-day period of care at the patient level was not collected on home health claims.  Effective January 1, 2023, Home Health Agencies (HHAs) may begin voluntarily reporting the new telecommunications G-codes on HH claims with HH periods of care that start on or after January 1, 2023.  On July 1, 2023, reporting these new codes will become mandatory with HH periods of care that start on or after July 1, 2023. 

Additional information is available at Telehealth Home Health Services: New G-Codes (cgsmedicare.com).

 
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