NAHC, NHPCO Sign Historic Affiliation Agreement

NAHC

On June 10, the Board Chairs and chief executive officers of the National Association for Home Care & Hospice (NAHC) and the National Hospice and Palliative Care Organization (NHPCO) met in Washington, D.C. to formally sign the affiliation agreement between the two leading organizations in the care at home community.

NAHC and NHPCO are the two largest organizations representing and advocating for providers of care in the home and the millions of disabled, elderly, and dying Americans who depend on that care. With more than 90 years of experience between them, NAHC and NHPCO provide world class education to help their members deliver the best possible care and tireless advocacy to expand access to home and community-based services.

“The NAHC-NHPCO Alliance will be the leading authority and unifying voice of the care at home community,” said NAHC Board Chair and Chair-Elect of the Alliance Kenneth Albert (second from left in photo). “The leadership of both organizations have worked for 18 months to make this happen and the talented staff at NAHC and NHPCO are already hard at work integrating the two organizations. Together, we will make home the center of health care.”

“This alliance between NHPCO and NAHC will create the most powerful voice the care at home community has ever had,” said NHPCO Board Chair and Vice Chair-Elect of the Alliance Melinda Gruber (second from right in photo). “For members, it means access to the best education and expert advice, as well as a strong advocate for sensible policies that help providers deliver the best possible care to the millions of Americans who need it the most.”

“The affiliation of NAHC and NHPCO is a historic event,” said NAHC President and CEO William A. Dombi (at left in photo). “Unifying the voice of health care at home has been a longstanding goal of NAHC, as it is the essence of the original formation of NAHC in 1982. Combining our two organizations will significantly strengthen that voice for the benefit of our members and the patients they serve.”

“The community of providers delivering care primarily in people’s homes is stronger when we work together,” said NHPCO Interim CEO, Ben Marcantonio (at right in photo). “We have demonstrated that strength in recent years with shared advocacy efforts and joint research that have helped change the conversation in Washington and beyond. Aligning NHPCO and NAHC into one new organization will mean we can better serve our members well into the future.”

The signing of the agreement takes NAHC and NHPCO into a new phase of an ongoing process. Beginning July 1, the organizations will begin integrating operations, a process that is expected to take the rest of the year.  That process will take place under the name the NAHC-NHPCO Alliance while the future name of the organization is determined. Considerable progress on a new name has been made and is in process of trademarking approvals. Meanwhile, a robust search for a CEO for the new organization is under way, with dozens of qualified candidates being considered.

‘An Absurd Amount of Denials’: New Legislation Seeks to Streamline Access to Home Health Services, Improve Senior Care

Home Health Care News | By Robert Holly
 
A group of bipartisan lawmakers this week reintroduced legislation aimed at curtailing restrictive – and often flawed – prior-authorization processes within Medicare Advantage (MA).
 
As it has been to most other parts of health care, prior authorization has long been problematic for home health providers and patients. That’s been increasingly true as more insurers have started to adopt systems and processes that use predictive analytics and algorithms to guide their decision-making, too.
 
In the Senate, the legislation – the Improving Seniors’ Timely Access to Care Act – was introduced by Sens. Kyrsten Sinema (I-Ariz.), Roger Marshall (R-Kan.), Sherrod Brown (D-Ohio) and John Thune (R-S.D.). Companion legislation was likewise put forth in the House, led by U.S. Reps. Mike Kelly (R-Penn.), Suzan DelBene (D-Wash.), Larry Bucshon (R-Ind.) and Ami Bera (D-Calif.).
 
“Right now, too many older Americans enrolled in Medicare Advantage are forced to deal with unnecessary delays when seeking out [care],” Sen. Brown said in a statement. “We need to update the Medicare Advantage program so it works better, faster, and is more transparent for patients and providers.”
 
If passed, the Improving Seniors’ Timely Access to Care Act would increase transparency around MA prior-authorization requirements and their use. It would additionally establish an e-PA process for MA plans, including a standardization for transactions and clinical attachments.
 
By digitizing parts of prior authorization, the hope is that some decisions could be reached faster – even in real time.
 
The Alzheimer’s Association, AARP, the American Hospital Association, the American Academy of Hospice and Palliative Care, and LeadingAge are among the many health and senior care groups to support the legislation. 
 
“By removing unnecessary barriers that create delays in treatment, this meaningful bill will improve access to care for seniors and allow caregivers to spend more valuable time at the bedside with patients and less time on burdensome paperwork,” American Hospital Association Executive Vice President Stacey Hughes said in a statement…

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NAHC Submits Comments on Consolidation In Home Care

NAHC

The National Association for Homecare &Hospice (NAHC) submitted comments in response to a joint request for information (RFI) by the Department of Justice, the Department of Health and Human Services, and the Federal Trade Commission.

The RFI requested public comment on transactions by health systems, private payers, private equity funds and other alternative asset managers. The agencies wanted to know more about these types of transactions in the health care industry and the impact on health care delivery of services and products. 

NAHC’s comments focused on strategies federal regulators could use to ensure high quality of care is provided by healthcare organization regardless of tax status or organizational ownership.

NAHC requested that federal regulators consider using existing program integrity and quality improvement and measurement strategies to help identify any adverse effects of private interest transactions in healthcare and consolidations of healthcare entities. While the Centers for Medicare & Medicaid Services (CMS) has quality performance measurement and reporting programs for many of its provider sectors to identify high quality and low quality performing providers, additional investment in these frameworks and tools is needed to mature the quality landscape for the care in the home community. As an example, NAHC has encouraged expansion of what is currently a limited set of meaningful hospice quality measures, calling for increased investments in measuring what matters to patients and families, and making quality data more transparent and easy-to-understand.

The recently finalized CMS Medicaid Access Rule (CMS-2442-F) which, among other things, includes new required reporting on the HCBS Quality Measure set as well as implementation of access to strengthened electronic incident management system. These improvements will increase the oversight of quality of care, person-centered service delivery, and health and welfare of participants.

Additionally, CMS could strengthen oversight for compliance with regulatory requirements, such as the conditions of participation, coverage, and payment, along with claims data analysis to detect aberrant behaviors. Further, provider enrollment requirements could be enhanced to identify private interest ownership and/or abnormal consolidation efforts of healthcare organizations. The effectiveness of these efforts could be greater if oversight and control is targeted towards known or suspected bad actors and towards geographic areas with unusual enrollment activity into the Medicare program.

Uninsured Rate Expected to Hit 8.9% Over Next Decade, CBO Finds

Healthcare Dive | By Rebecca Pifer
 
New government projections chart the dogged rise in the nation’s uninsured rate as policies that swelled healthcare coverage during the coronavirus pandemic expire.

The projections reverse how insurance coverage ballooned during COVID-19. The number of Americans without health insurance dropped by about a fourth from 2019 to 2023, thanks to government policies bolstering coverage, according to National Center for Health Statistics data released Tuesday.
 
One such policy is enhanced marketplace subsidies passed in the American Rescue Plan in 2021 and extended by the Inflation Reduction Act one year later. The laws expanded eligibility for premium tax credits to people with incomes greater than 400% of the federal poverty level, and increased subsidies for people who were previously eligible.
 
The number of people enrolled in ACA plans have soared as a result, and is expected to keep rising. Enrollment in the exchanges is expected to reach a historic high of 23 million people next year, according to the CBO — at which point the subsidies are scheduled to expire.
 
If they expire, ACA enrollment will decline by about 7 million to 8 million people, the report estimates. Some of those people will find insurance through their job. However, about 5 million people will become uninsured, CBO analyst Sean Lyons said during a Tuesday media briefing.
 
There has been some movement in Washington to extend the subsidies, including from President Joe Biden, who has made doing so a key part of his healthcare platform in the 2024 presidential election. 
 
However, Republican opponents point to the dramatic increase in federal spending as a result of the more generous financial assistance. If the subsidies are extended, it could increase the federal deficit by $335 billion over the next decade, Lyons said.
 
Medicaid is another insurance program that’s expected to see its membership drop significantly in the near-term.

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