WellSky [formerly, Mediware Information Systems (Lenexa, KS) a health and community care technology company backed by TPG Capital; and Citus Health (New York, NY), a digital health solutions provider for post-acute care providers have formed an exclusive new partnership. Together, WellSky and Citus Health are launching an integrated, web-based, and mobile patient engagement module that enables WellSky CPR+ and CareTend home infusion clients to improve documentation processes and communication between patients and clinicians.
©2019 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. homecaretechreport.com editor@homecaretechreport.com
By Jordan Rau, Kaiser Health News
Eight hundred hospitals will be paid less by Medicare this year because of high rates of infections and patient injuries, federal records show.
The number is the highest since the federal government five years ago launched the Hospital Acquired Conditions (HAC) Reduction Program, created by the Affordable Care Act. Under the program, 1,756 hospitals have been penalized at least once, a Kaiser Health News analysis found.
This year, 110 hospitals are being punished for the fifth straight time. [Types of penalties incurred for preventable incidents in hospitals are identified, such as sepsis, bedsores, hip fractures and other complications. It’s noted:”Under the latest round of sanctions, each hospital will lose 1 percent of its Medicare payments for patients discharged between last October and this September. That comes on top of other penalties created by the health care law, such as annual payment reductions for hospitals with too many patients being readmitted.”]
©2019 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. editor@homecaretechreport.com
By Tim Rowan, Editor and Publisher of Home Care Technology Report
Today [April 10, 2019], the Centers for Medicare & Medicaid Services (CMS) finalized policies that will increase plan choices and benefits, including allowing Medicare Advantage plans to include additional telehealth benefits. These policies continue the agency’s efforts to modernize Medicare Advantage and Part D programs, unleash innovation and drive competition to improve quality among private Medicare health and drug plans. [According to CMS Administrator Seema Verma, “Today’s policies represent a historic step in bringing innovative technology to Medicare beneficiaries… [and, “With these new telehealth benefits, Medicare Advantage enrollees will be able to access the latest technology and have greater access to telehealth. By providing greater flexibility to Medicare Advantage plans, beneficiaries can receive more benefits, at lower costs and better quality.”]
For a fact sheet on the CY 2020 Medicare Advantage and Part D Flexibility Final Rule (CMS-4185-F), please visit: https://www.cms.gov/newsroom/fact-sheets/contract-year-2020-medicare-advantage-and-part-d-flexibility-final-rule-cms-4185-f
The final rule can be downloaded from the Federal Register at: https://s3.amazonaws.com/public-inspection.federalregister.gov/2019-06822.pdf
©2019 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article was reprinted in Tim Rowan’s Home Care Technology Report from a CMS news release, at homecaretechreport.com Further reproduction is encouraged. editor@homecaretechreport.com
by Darcey Trescone, RN, BSN
[The Patient-Driven Groupings Model will change the way home health is paid starting next year…and this article shares viewpoints of representatives from 3 leading software vendors–Netsmart, Axxess and OperaCare–and discusses what each of them is doing to support the industry in their own words, and most particularly they focus on how PDGM is impacting the healthcare at home industry. As one example, Billie Whitehurst, MS, RN and also the VP and GM of Home Care Solutions at Netsmart, asserted: “PDGM is not about just one thing… “It is really about changing the way home health works. Ultimately, it is a journey toward value-based care, driven by CMS.” Others focused on the newer drive toward efficiencies and value-based care in healthcare at home.]
Other HHA spokespeople interviewed for this piece also noted a newer role for software development companies to assist in PSGM needs. One suggested that software vendors must find means to assist HHAs by helping them with designing systems to educate and coach their clients and so support PDGM. As Stephen Rhoades, a Netsmart Operations Consultant, added, explaining how Netsmart is doing so: “We have created customizable roadmaps for our client agencies. Some are deploying tools complementary to the EMR such as our revenue cycle management or coding services.”
Tammy Ross with Axxess explained, “In addition to our PDGM Modeling tool, we are looking at home health agency operational processes. One simple example is we have added pop-ups in scheduling that let the end user know the LUPA threshold for each clinical grouping. Clinically, we have built episode management and pathway tools that help agencies manage outcomes with appropriate interventions and goals. At the point of care, we have tools that guide the clinician to assess and monitor for exacerbations of secondary diagnoses, and offer notifications regarding compliance with the care plan.“
Author Trescone notes in conclusion about the inception of PDGM: “As this major regulatory change approaches, we are seeing innovative tools surfacing that support providers’ need to comply with CMS’s push toward value-based care.”
©2019 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. editor@homecaretechreport.com
Cloud-based provider AlayaCare is expanding how it supports the home care industry, particularly the home infusion market, through data collection, support of the intake process, and analysis of performance.
AlayaCare’s APIs [defined in Wikipedia as a set of routines, protocols, and tools for building software applications] for interoperability, remote monitoring, schedule and route optimization, machine learning/AI, and portals all increase agency efficiency and streamline administration.
With the home infusion therapy market showing significant growth, estimated to be worth $135 billion in just five years, it is now imperative for providers to modernize and use technology to capture data across all areas of operations.
By Tim Rowan, Editor & Publisher of Home Care Technology Report
A new report from Harvard Joint Center for Housing Studies, “Improving America’s Housing, 2019,” shows that Americans over 55 years of age spend $152 billion per year on improving their homes. These are just the people who are already remodeling.
It seems a no-brainer to encourage these low hanging fruit homeowners to update their homes for “modern longevity.” There is a precedent: The Hartford Insurance Company Center for Mature Market Excellence partners with the USC Leonard Davis School of Gerontology to provide homeowner education at the time of a claim to impact decision-making about home modification.
In their study, “Top Smart Home Technologies for Mature Home Owners,” Hartford and MIT AgeLab staff conducted an extensive review of 25 smart home technologies. The panel reviewing the technologies consisted of leading experts in housing, aging, and technology from the fields of occupational therapy, interior design, computer science, gerontology, and engineering, plus a survey of homeowners.
The panel identified smart home technologies that may particularly benefit homeowners who have a health condition or are caring for a family member. The focus is to help homeowners and caregivers maintain safety, independence, and well-being at home.
The top 5 technologies that the panel identified [include:] Telemedical management systems; medication management systems, smart fall detection systems; smart beds, and sleep sensors. Susan Kimmel and Louis Tenenbaum used this new data to highlight HomesRenewed at the Intercompany Long Term Care Insurance conference last week in Chicago.
A strength of the HomesRenewed Coalition is the broad interest in updating homes. Through the coalition, Long Term Care Insurers, home care agencies, remodeling, technology, healthcare and more business sectors join consumers in saying:
“It is fundamentally unjust to continue medical miracles that add years to lives without also updating homes to live those lives joyfully with dignity.”
The HomesRenewed Coalition opens the door to change.
Incentives are a national topic: HR 1780, a bipartisan bill in the last Congress, called for a $30,000 tax credit. HomesRenewed is working to bring an improved bill to the new Congress.
And worth noting: The breadth of the HomesRenewed Coalition has unprecedented power to move ideas into action. Congress will listen when so many diverse segments of the economy focus on the same topic.
The HomesRenewed Coalition supports the elderly constituency’s planning home updates on Main Street, Wall Street and Capitol Hill. Tenenbaum issued an invitation for home care providers to help make it happen. Information is available here about joining HomesRenewed.
©2019 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. editor@homecaretechreport.com
By Elizabeth E. Hogue, Esq.
The world is discovering the value and “beauty” of home care of all types, and now everyone wants to benefit and perhaps profit from such services! It’s awfully nice to be appreciated, but some of the proposals “to get on board the home care train” cause concern, at least initially.
[Hogue provides a detailed example the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) posting Advisory Opinion No. 10-03 on March 6, 2019, which permits hospitals to provide free, in-home follow-up care to discharged patients. During home visits, paramedics employed by the hospital will provide a long range of services, such as vaccinating patients and many other services that are typically provide by registered nurses (RNs) and therapists utilized by home health agencies. Hogue questions why hospitals would not enlist these personnel rathe than paramedics? Hogue continues with supplying a news story about UPS’s plans to use its very large healthcare complex –location not disclosed– and package vaccines there from which it will
ship them to 4700 UPS stores. Hogue raises many questions about these plans: Key among them is: At those UPS stores, a home health nurse who is contracted by a UPS clinical trial logistics unit, called Marken, will gather the vaccines and transport them to the patient’s home. The nurses will administer the vaccines in the home. Hogue continues:
The above information raises a number of issues, such as whether UPS will use nurses from home health agencies to vaccinate patients. If not, must UPS become a licensed home health agency in the states in which it provides this service? And let’s not forget that home health agencies have provided flu vaccines for many years!
It’s encouraging to receive greater recognition of the value of home health, but home care providers are the best at providing home care services of all kinds. They’re the pros! It seems reasonable to expect those who want to get on board the home care train to use the pros to do so.]
©2019 Elizabeth E. Hogue, Esq. All rights reserved. No portion of this material may be reproduced in any form without the advance written permission of the author.
Update to Public Reporting of the Hospice Visits When Death is Imminent Measure Pair
The “Hospice Visits when Death is Imminent” measure pair assesses whether a hospice patient and caregiver’s needs were addressed by hospice staff in the last three and seven days of life. The three-day “Hospice Visits when Death is Imminent” measure will be publicly reported on Hospice Compare in summer 2019, as planned.
[It’s noted, however, that: The seven-day “Hospice Visits when Death is Imminent” measure will not be publicly reported at this time because it did not currently meet readiness standards for public reporting. Additional time will allow further testing to determine if changes to this measure or how it would be displayed on Hospice Compare are needed, and to ensure the measure’s accuracy and reliability as an indicator of provider quality.
For more information please see the “Public Reporting of the Hospice Visits when Death is Imminent Measure Pair Fact Sheet” in the Downloads section of the Public Reporting: Background and Announcements webpage.
CMS: Beyond the Policy
Today, the Centers for Medicare & Medicaid Services (CMS) is releasing the latest episode of our podcast, CMS: Beyond the Policy. This episode brings highlights from the 2019 CMS Quality Conference. An annual event attracting over 3,000 participants this year had a strong focus on reducing clinician burden so they can focus on patients, promoting health care choice and driving value based care. You will find highlights from CMS Administrator Seema Verma’s keynote speech where she discussed the vision for Medicare and the agency this year as well as audience reaction. We hope you enjoy this condensed version of the conference knowing that it’s not always possible to attend in person. You can listen to the podcast here as well as on Google Play and iTunes.
Home Modification to Support the Aging Population (4/3/2019)
If Boomers are going to stay in their homes into old age, they need no only in-home healthcare, but a home that works for them. Can your agency make money by advising your clients about remodeling?
Vendor Watch (4/3/2019)
— AlayaCare expands into Home Infusion
Clairvoyant Networks to Provide Technology for Texas A&M R
By Tim Rowan, Editor and Publisher of Home Care Technology Report
On Monday[March 25. 2019], CMS announced that the Administration has granted another one-year extension to an executive order that allows insurance companies to sell policies that do not meet “minimum essential coverage” regulations of the Patient Protection and Affordable Care Act. The announcement, reprinted verbatim elsewhere in this week’s issue, spins the extension as an opportunity for people to buy an affordable health insurance policy when they make too much money to qualify for premium subsidies but not enough to afford a market rate policy.
We looked into it and came away uncertain that CMS should be describing exempting some insurance policies from ACA standards as “an opportunity.” It may also cause payment problems for home care agencies providing services, assuming they will be reimbursed by a health insurance policy. [Rowan pursues this line of questioning– but only reaches conclusions for his readers that beg answers. He provides the history of the health insurance problem in the U.S., that began in 2013, when President Obama’s administration gave citizens going without health insurance when they switched jobs, and received a short-term opportunity to purchase non-ACA-compliant health insurance policies rather than go without insurance for a month or more when they moved from one job and one employer-provided insurance plan to another. Typical characteristics of a non-compliant policy were:
lower monthly premiums than can be found on the exchanges;
not being required to cover claims determined to result from pre-existing conditions; and many more such questionable policy benefits.
In other words, these are the types of policies that the ACA intended to eliminate, and policies that charge premiums but almost never pay for care. As Rowan notes: In July 2017, Congress failed to pass a bill that repealed major parts of the ACA– a bill that the then-President Trump’s Administration believed would lower monthly health insurance premiums. In Oct. 2017, in a Plan B effort to slow the rapid rise of insurance premium sums, Congress issued an executive order to change the wording of CMS’s 2013 exemption from a “3-months a year or less” to “less than a year.”
Specifically, the order declared CMS would not enforce requirements that such policies adhere to the ACA minimum time requirements. But almost immediately, some insurance companies began to sell less costly 364-day policies but only to healthy people with no pre-existing conditions. There were several consequences to these changes surrounding insurance policy changes, Rowan notes, some intentional, some not, perhaps.
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1 https://www.commonwealthfund.org/blog/2017/new-executive-order-expanding-access-short-term-health-plans-bad-consumers-and-individual?redirect_source=/publications/blog/2017/aug/short-term-health-plans#/
©2019 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. editor@homecaretechreport.com
Administration Will Not Enforce Regs Against Non-ACA-Compliant Health Policies
CMS announces an extension of the right to buy health insurance policies not subject to
By Randy Pate, Director, Center for Consumer Information and Insurance Oversight
Insurance Standards Bulletin Series – INFORMATION – Extension of Limited Non-Enforcement Policy through 2020
Subject: Extended Non-Enforcement of Affordable Care Act-Compliance With Respect to Certain Policies.1
This article covers CMS’s announcement of an extension of the right to buy health insurance policies not subject to ACA minimum standards. It goes through detailed particulars regarding which insured groups (such as small groups and individuals) are affected or not, and under which specific time periods. Readers are advised to refer to
this specific article for particulars about new insurance changes that are specific to small groups or to individuals.
If you have any questions regarding this guidance, please e-mail CCIIO at marketreform@cms.hhs.gov.
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©2019 by Rowan Consulting Associates, Inc., Colorado Springs, CO. homecaretechreport.com This article is a reprint of a CMS news release. It may be freely copied. editor@homecaretechreport.com
