Healthcare at Home: The Rowan Report

Today, the Centers for Medicare & Medicaid Services (CMS) announced 121 new participants in Medicare Accountable Care Organization initiatives designed to improve the care patients receive in the health care system and lower costs. With this announcement, ACOs now represent 49 states and the District of Columbia. [Details in next week’s issue.]

The January refresh of the Home Health Compare website will occur on January 28^th. The data presented on HHC in January will match those presented in the preview reports that were uploaded to CASPER in October. Any questions about these reports can be directed to HomeHealthQualityQuestions@cms.hhs.gov.

IMPACT ACT TRAINING: Connecting Post-Acute Care Across the Care Continuum

Thursday, February 4 from 1:30 to 3 pm ET

To Register: Visit MLN Connects Event Registration. Space may be limited, register early.

The Improving Medicare Post-Acute Care Transformation Act of 2014 requires the reporting of standardized patient assessment data by Post-Acute Care (PAC) providers, including skilled nursing facilities, home health agencies, inpatient rehabilitation facilities, and long-term care hospitals. It specifies that data elements must be standardized and interoperable to allow for the exchange and use of data among these PAC and other providers, including common standards and definitions to facilitate coordinated care and improved beneficiary outcomes. During this call, CMS subject matter experts and the Office of the National Coordinator for Health IT discuss the implications of the IMPACT Act for health information exchange across the care continuum.

Agenda:

• Requirements to standardize and make interoperable post-acute care assessment data elements
• Using and exchanging clinically relevant assessment data for multiple purposes
• Health Information Technology Standards – A Primer
• CMS Data Element Library
• Electronic health information exchange

Target Audience: Providers across the care continuum, including long-term/post-acute care and home and community-based service providers, acute and primary care providers, integrated delivery systems and representatives from other payment models, health IT vendors, and other interested stakeholders.

Continuing education credit may be awarded for participation in certain MLN Connects Calls. Visit the Continuing Education Credit Information webpage to learn more.

FY 2017 and After Payments to Hospice Agencies That Do Not Submit Required Quality Data MLN Matters® Article — Released
An MLN Matters Article on Fiscal Year 2017 and After Payments to Hospice Agencies That Do Not Submit Required Quality Data – This CR Rescinds and Fully Replaces CR9091 is available. Learn about changes to the payment reduction reconsideration process and general clarifications to the revised Medicare Quality Reporting Incentive Programs Manual, Chapter 3, Section 40.

©2015 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

I chose topics, verbiage, images and methods that were perceived as negatives by Boomers (old age, handicaps, health issues, financial problems, etc. … things so often attributed to a less-than-stellar aging experience). I put them into a message that essentially stated, ‘You know all of this is true, even if you don’t want to admit it, so you should plan for it.’ (Mark Hager’s 9/14/15 blog link)
Of course, Hager, along with other designers, engineers, and healthcare at home staffers of all stripes, are working on ideas, if not actual products, to help seniors live well at home. With or without the dreaded “A” word, these ideas and products are needed for seniors’ comfort and safety as they age.

[This article focuses on new and much-needed means for addressing healthcare needs of seniors who are “shut-ins”–attention is given to a Selfhelp Community Services, Inc, a senior care-oriented organization that brings virtual programming via televisions in seniors’ own residences. The value of the program is assessed and a suggestion is made that CMS cover the costs of what’s proven to be therapeutically advantageous educational TV and chat rooms.]

Beyond Meeting Physical Needs in Chronic Care

For healthcare at home workers servicing these patients, going beyond providing usual services indicated on their care plans is a challenge not likely to be met, given time and funding constraints. Yet, more is required to keep these seniors healthier and happier, contends healthcare at home author, Amy Baxter. In her “Tech Innovation Improves Home Health’s Cost-Care Equation,” published last year in Home Health Care News (Oct. 25, 2015), she notes the need for keeping seniors engaged and feeling healthy in the home setting, stating, too, that: “The consequences of isolation can negatively impact not only seniors’ health, but drive up costs to the provider and health system at large.” And she introduces one such solution to keeping seniors from being “shut out.”

A TV programming antidote
Selfhelp Community Services, Inc. is a nonprofit health care service provider trying to address this seniors-being-shut-out issue. It currently serves 20,000 seniors in New York City, but its scope is farther reaching. Selfhelp has developed a virtual senior center, a system that offers live, interactive classes and exchanges for seniors in New York City, Chicago, Baltimore and San Diego. The system uses a 22-inch touch screen desktop computer that sends programming directly into the home of an isolated senior.

Engaging programming includes yoga, music and art classes. Unlike the Senior Learning Network that we profiled in HCTR last March (Home Care Tools for Today’s Senior Populations, which requires seniors to travel to a designated senior activity center to view educational activities, offerings from Selfhelp not only accommodate the homebound senior but also has developed facilities for setting up chat rooms and other means for the senior shut-ins to reach out to engage with one another.

According to Stuart Kaplan, CEO of Selfhelp, the programming is the most important component of the offering, but seniors have formed their own groups and chatrooms outside of classes as a result. Studies undertaken with viewers note a significant decline in feelings of loneliness and isolation. As many as 85% of senior viewers, whose average age is 83, report a reduction of feelings of isolation and depression.

Author Baxter concludes about this reportage: “Shut-ins are no longer shut out.” For now.

Paying For Self-Help Services to Senior Shut-Ins
Currently, this television programming service is paid for by grants from the Consumer Electronics Association Foundation and the AARP Foundation. Consequently, as it only serves a small population, it faces a huge funding hurdle to expand, according to Selfhelp’s CEO Kaplan. Without said grants, the cost to seniors would be about $600 to purchase the software and touch screen device, while service would run about $60 per month.

So far results are promising—the significant numbers of seniors reporting reduction of feelings of isolation and depression, is one case in point. That’s why Selfhelp’s Kaplan perceives a likelihood of Medicare eventually paying for this needed service as a therapeutic one.He has noted his vision of Selfhelp’s being perceived as offering “blended care,” which integrates housing and health care.According to Kaplan, his company’s blended care approach mirrors changing CMS payment methods, which are moving toward recognizing value over volume of care. “We espouse that we are living at the intersection of social housing, affordable housing and health care,” Kaplan has said. “Technology is one aspect that fits within the blended services and ultimately should fit into a payment system of bundled payments.” Therapeutically advantageous educational TV and chat rooms are one way to provide value to at-home seniors.

Kaplan predicts that in the not-distant future, aging boomers themselves will demand technological innovations like Selfhelp’s communications offerings to help them thrive at home. Mark Hager is surely waiting for the day when boomers and the elderly are the same people.
Audrey Kinsella, MA, MS, is HCTR’s telemedicine reporter. She has written on home telehealthcare and new technologies for home care service delivery for 20 years, in 6 books, multiple web sites, and more than 150 published articles. Audrey can be reached at audreyk3@charter.net or 828-348-5308.

©2015 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

press release from Markets and Markets, Inc.

Home healthcare is one of the fastest growing sectors in the U.S., reaching an estimated $100 billion this year. There are currently 10 to 12 million people receiving home healthcare, and those numbers are expected to increase dramatically due to an increase in the population aged above 65 and the preference to be treated at home. With a rise in subsidy cuts, upgrades in technology and the penalty on re-hospitalization of patients, this industry faces challenges on a daily basis which need to be dealt with by the senior managements of Home Healthcare Agencies. [A full description of an upcoming conference, the “Home Healthcare Leaders’ Summit,” in Los Angeles, on March 3-4, organized by MnM Conferences, is presented in this short article.   It’s noted that speakers will include representatives of The Joint Commission, Visiting Nurse Associations of America, healthcare at home organizations, and law firms. Special attention is paid to speaker Michael J. Demoratz, Palliative Care Administrator – Supportive Care at 24/7 Care At Home in California will speak on “Advance Care Planning and Palliative Care and his work on readmission challenges and the importance of advanced planning.]

Keeping in mind many recent financial, legal and technological developments in the industry, Key Home Healthcare Developments to be discussed at Los Angeles Conference is organizing a Home Healthcare Leaders’ Summit, set for March 3-4 in Los Angeles. The summit is designed to be an exclusive gathering of C-Level executives to learn, discuss and debate industry best practices to combat the strategic challenges being faced by senior management of home healthcare agencies nationally. Speaking at the summit are representatives from organizations such as The Joint Commission, Visiting Nurse Associations of America, Aurora at Home, Visiting Nurse Service of New York, United Home Care, Southland Home Health, National Nursing & Rehab Inc., At Home Operations, A-1 Healthcare Management, Fenton Law Group, Duane Morris and Davis Wright Tremaine.

Michael J. Demoratz, Palliative Care Administrator – Supportive Care at 24/7 Care At Home in California will speak on “Advance Care Planning and Palliative Care – the key to addressing the readmission challenge.” We at MnM Conferences recently did a short interview with Michael, talking about the latest developments in the industry. Speaking about the latest technological changes that have been introduced in the industry recently, Michael said, “We live in interesting times – technology that can provide for data collection, educate and perform some of the more mundane processes replacing humans will be empowering for patients.  For example, there is a significant value of objectively measuring vital signs and collecting this information and then only reporting trends or outlier data points to clinical staff will assist in proactively managing the patient successfully in the community.”

When asked about the key take-aways from his presentation, he said, “The most important thing for the audience to know is the impact that the conversation surrounding advance care planning can have on this population of seriously ill individuals – education provided by properly trained healthcare staff – can facilitate real change in patient behavior – hi emotional  touch conversations designed to ensure patients and families have an opportunity to discuss goals of care and have realistic expectations set can impact the cost of care by a factor of more than 10.”

Nationally recognized as a subject matter expert on end-of-life care, presenting at several national and regional conferences, Michael has 35 years of experience in end of life and senior care coordination. He presently serves on the Boards of both the Coalition for Compassionate Care of California and as an elected Commissioner for the Commission for case manager Certification (CCMC).

Topics of discussion at the summit include understanding the role of the implications of the face-to-face physician lawsuit, delivery system transformation and payment model alignment for home health, the role of home care in changing how healthcare is delivered, deploying telehealth applications to save a billion dollars annually in healthcare costs, surviving a government health care fraud audit/investigation, improving clinical outcomes with the help of telehealth and reducing hospitalization, deploying cloud-based platforms to revolutionize the home healthcare industry and evolving relationships with hospitals, ACOs and other clinically integrated networks (CINs).

With an effective blend of case studies and presentations along with one-on-one meetings with leading solution providers, the summit will be excellent opportunity for delegates to not only update their organizations with latest and best industry practices but also share expertise with industry peers. The event is sponsored by Community Health Accreditation Partner and Kinnser Software.

©2015 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