Home Health Providers See Age-Friendly Accreditation As Competitive ‘Differentiator’

Home Health Care News / By Andrew Donlan
 
Last year, the Community Health Accreditation Partner (CHAP) received part of a $2.3 million grant from The John A. Hartford Foundation (JAHF) to bring the Age-Friendly Health Systems movement to home-based care.
 
Almost a year later, home health providers have implemented the framework – including Enhabit Inc. (NYSE: EHAB) and Compassus – and are seeing it as a potential differentiator moving forward.
 
“It’s competition in a way that makes everybody better,” Bud Langham, the EVP of clinical excellence and strategy at Enhabit, told Home Health Care News. “You can see that in the Age-Friendly Health Systems, there’s thousands of organizations who’ve already gone through a similar process on the inpatient side. You don’t want to be that one system in a marketplace that hasn’t been certified age-friendly. My hope is every single market where we achieve this certification, it raises the bar so that everybody has to step up.”
 
Based in Dallas, Enhabit provides home health and hospice services across 252 home health locations and 105 hospice locations in 34 states.
 
The age-friendly framework is supposed to elevate care for patients, but in a way that also benefits their families, referral sources and payers. It concentrates on “what matters”, medication, mentation and mobility – the “four Ms.”
 
As more care is moved to the home, age-friendly advocates – namely CHAP – believe this is a way to elevate the industry as it gains a brighter spotlight. Beginning in April, home health providers across the country have had the option to achieve a certification for Age-Friendly Care at Home.
 
“The only way we can really move the needle on outcomes is through patient involvement,” CHAP COO Teresa Harbour told HHCN. “And this is exactly what care this does, it gets that patient involved in their care. This is a perfect opportunity for organizations to provide that staff education on how to engage patients in their care and how to talk to them and determine what matters to them.”
 
A value-based care driver
 
Providing care in line with a patient’s goals was always sensical. But, the four Ms around Age-Friendly Care at Home fit in perfectly with the Home Health Value-Based Purchasing (HHVBP) Model as well.
 
Part of the calculation behind HHVBP is patient satisfaction scores. If patients are receiving care that they believe is specifically tailored toward them, providers are much more likely to receive high scores from those patients…

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Colorado Enacts Legislation Restricting Employers from Requesting Age-Related Information from Job Applicants

​Health Care Association of America (HCAOA)

On June 2, Colorado Gov. Jared Polis signed into law Senate Bill 23-058, the Job Application Fairness Act (JAFA), prohibiting employers from inquiring about a job applicant’s age during the hiring process. JAFA’s enactment adds to the requirements and proscriptions Colorado has implemented in the hiring process, including a “ban-the-box” restriction on inquiring about criminal histories and requiring the inclusion of salary and benefits information in job postings.

Click here to learn more from HCAOA partner Littler.

Dombi: In Advance of Proposed Rule, Agencies Fighting ‘Medicare Home Health War’

McKnight’s Home Care | By C. MAX BACHMANN
 
National Association for Home Care & Hospice President William Dombi issued a frank assessment of the state of home healthcare Thursday in advance of the release of the Centers for Medicare and Medicaid Services’ proposed payment rule for 2024.
 
“There is intense congressional action going on,” he said Thursday in a webinar hosted by the Polsinelli law firm. “Regulatory response is in play. Even litigation is on the agenda as well. This is the equivalent of a Medicare home health war at this point in time.”
NAHC and other associations are anticipating a rate cut in the proposed rule. 
 
“We’re days away from seeing the proposed payment rule for 2024,” he said. “There’s a lot we’re watching for there with potential for a proposed rate cut that ranges from low single digits to mid teens [that would] really be putting the delivery of care in jeopardy.”

The permanent behavioral adjustment of -3.925%, which went into effect this year, has contributed to staffing shortages, which have resulted in a drop in hospital-to-home health conversion rates, he told McKnight’s Home Care Daily Pulse earlier. A temporary rate adjustment — so-called clawback payments related to the Patient-Driven Groupings Model — also could surface in the proposed rule. It could total billions of dollars.
 
Medicaid Access Rules
 
Home care already is dealing with the aftermath of two other significant rules from CMS proposed in April. 
 
Ensuring Access to Medicaid Services (Access NPRM) and Managed Care Access, Finance, and Quality (Managed Care NPRM) would require home- and community-based services (HCBS) to publish average hourly rates paid to direct care workers and strengthen person-centered service planning, among other provisions. Perhaps the most controversial requirement is that 80% of Medicaid payments for personal care, homemaker and home health aide services be spent on compensation for direct care workers.
 
“Essentially, the states would report data each year on the proportion of the total amount of Medicaid expenditures they had for these three services and the proportion of that that was provided to the workers,” NAHC Director of Medicaid HCBS Damon Terzaghi explained Thursday. 
 
Providers have voiced their displeasure with this measure. Last week, Addus HomeCare CEO Dirk Allison noted that the rules would “disproportionately” affect caregivers in states that pay them less and put “a vast majority of the small mom-and-pops” out of business. 
 
Terzaghi expressed frustration that the 80/20 measure is distracting from the other positive provisions within the text.
 
“We’re partially frustrated about this 80/20 proposal not just because of the challenging policy and, we think, the unsupported mandate they’re putting on providers, but also because it’s sucking the oxygen out of the room for so many potentially positive changes that were included in this regulation,” he said. 
 
Angelo Spinola, Polsinelli’s home health, home care and hospice chair, pointed out to providers that the rules are not yet final and that there is an open comment period until July 3. He also noted that associations and providers are working on issuing statements.
 
“This is one of those areas where a loud and uniform voice is going to make a significant difference,” he said. “This isn’t going to be a one-and-done type of situation. The rule would not actually go into effect until four years after the final publication.”…

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Home Healthcare Spending to Grow by 7.7% from 2025 to 2031, New Study Finds

McKnight’s Home Care | By C. MAX BACHMANN
 
Home healthcare spending will surpass $250 billion by 2031, according to new estimates released in a study published in Health Affairs Wednesday from the Office of the Actuary (OACT) at the Centers for Medicare & Medicaid Services (CMS).
 
Projections also indicate that spending will hit $141.5 billion this year and $149.3 billion in 2024. From 2025 to 2031, CMS predicts that home health spending will increase at a rate of 7.7%. 
 
As home health spending increases, so too will general healthcare spending, which CMS projects will reach $4.6 trillion in 2023 and balloon to nearly $7.2 trillion by 2031. 
 
Healthcare spending is growing faster than other sectors, Sean Keehan, an economist in the OACT at CMS and the Health Affairs study’s first author noted.
 
“Recent legislation is anticipated to affect trends in health insurance enrollment and healthcare spending over the next decade,” he said in a statement. “Altogether, and consistent with its past trend, health spending for the next ten years is expected to grow more rapidly, on average, than the overall economy.”
 
CMS projects Medicare spending will rise from 4.8% in 2022 to 8% in 2023 with expenditures expected to exceed $1 trillion. By 2031, Medicare spending is predicted to exceed $1.8 trillion, expanding at a rate of 7.8% per year, the study said.  The study also estimates that Medicare enrollment will reach 76.4 million by 2031, with overspending per enrollee hitting $24,000 that same year.
 
Medicaid spending, however, is slowing down after three years of over 9% growth during the COVID-19 pandemic. CMS projects that Medicaid spending will increase 3.7% in 2023 to $834.4 billion but then decrease by 2.1% to $816.7 billion in 2024.
 
CMS predicts that Medicaid enrollment will also decrease. After a historically high figure of 90.4 million enrollees in 2022, CMS expects enrollment to decline to 81.6 million in 2024.