State Budget Cuts Impact Home Health Care

December 8, 2016

The Home Care Alliance participated in several calls with MassHealth and Health and Human Services on planned budget cuts from Governor Baker’s administration. In total, the Governor announced $98 million in cuts from the $39.25 billion state budget.

Although there are reductions in home health, there are positive rates increases to report.

After years of advocacy by the Alliance and more recent efforts from a coalition of continuous skilled nursing providers as well as a family-based network called the Mass. Pediatric Nursing Campaign, MassHealth informed the HCA that payment rates for Continuous Skilled Nursing will increase by 2.6%. According to MassHealth, this equates to a $2.2 million bump in rates, which will become effective January 1st, 2017.

For the RN and LPN day and night rates, the increase hovers around a $1 boost in what those agencies currently receive. The Alliance, along with the provider coalition and family-based campaign, will continue to advocate for further adjustments to continuous skilled nursing rates in the upcoming FY18 state budget cycle.

As for home health skilled nursing rates outside of CSN, payment will be reorganized by the length of service of the MassHealth member. As of July 1, 2017, MassHealth is planning to break up the current skilled nursing rate for home health agencies into three separate tiers. The first tier will be for patients on services from day 1 through 30, which will be increased from $86.99 to $89.21. The second rate tier will be 31-180 days and the third rate tier is any home health service beyond 180 days.

MassHealth has indicated that the rates in the second tier will remain relatively static and the third tier will be decreased, but post 30-day rates as of 7/1/17 will be budget neutral from the changes taking effect on January 1st. An announcement from EOHHS will specifically outline the new tiered rates, but according to MassHealth, anything regarding rates that is seen before the New Year is not finalized and therefore subject to change.

The other notable decrease will take effect on January 1st when MassHealth plans to approximate the budget impact of those proposed second and third rate tiers into the current post 60-rate. The cut in the post 60-day rate from 1/1/17 to 7/1/17 will be a 6.75% reduction. This means the current post 60-day rate of $69.59 will be roughly $64.89 for the first six months of 2017. (This rate remains higher than the medication administration rate originally considered by MassHealth.)

Laid out in another way, this will be how rates are currently planned to change:

January 1 – July 1:

Home health services post 60-day rate will be roughly $64.89 (6.75% reduction)

July 1:

Service days 1-30: $89.21

Service days 31-180: Rates will remain roughly the same, but are not yet finalized

Service days 180: Rates will be slightly reduced from the current post 60-day rate, but are not yet finalized.

MassHealth is also streamlining enrollment in the Independent Nursing program to cut their application process from 8 weeks down to one week.

The net state cut for home health is approximately $3.8 million out of $758 million in MassHealth spending on home health care services.

Most of the other cuts announced by the administration are restoring vetoes previously proposed by the Governor in the FY2017 budget, but that were overridden by the legislature. At that time, the Governor vetoed $255 million and the legislature overrode $231 million. Included in these cut overrides are certain hospital supplementary payments (particularly to pediatric and Western MA hospitals) as well as $1.1 million in cuts to public health hospitals.

Other impacted accounts include supplemental payments to nursing homes, which will be reduced by $2.8 million, as well as a $2.8 million cut to adult foster care (AFC).

The Pediatric Palliative Care account (4590-1503) is being reduced by $400,000.

The legislature has already announced their view that Governor Baker went too far with some of the announced cuts and they will be working on restoring some of the funding reductions.

HCA of MA has an upcoming meeting with MassHealth to review the Governor’s proposal.  Also on the agenda are issues with ICD-10 changes that are impacting agency billing and payment.

Return to www.thinkhomecare.org.


Everything You Want to Know About eLearning Partnership with Corridor Group in One Place

November 30, 2016

elearning-top

The Home Care Alliance of Massachusetts has partnered with the Corridor Group to provide an exciting new membership benefit. Corridor Campus eLearning is an online program that provides orientation and ongoing education for all levels of staff, allowing you to streamline training across your organization while providing Continuing Education Credits. Topics of the 150+ courses offered include ICD-10, Sexual Harassment, Alzheimer’s, HIPAA, Infection Control, and much more!

Home Care Alliance member agencies receive a discounted rate on Corridor Campus, paying the lowest per user fee they offer. Along with this great offer, our members will also have the opportunity to receive a 15% discount on any other Corridor products they purchase.

After the partnership was announce this summer, the Home Care Alliance held an informative webinar that introduced the software and did a brief demo. All information about this partnership including the recording of the webinar is available at www.thinkhomecare.org/Corridor. Take a look at this great opportunity to save your agency money while receiving great education for your staff!

If you have any questions about this partnership you can contact Megan Fournier at mfournier@thinkhomecare.org

Click Here to go to eLearning Partnership Page to Learn More!


Advocacy Alert: Urge Congress to Delay Pre-Claim Review via the PUSH Act

November 16, 2016

With the election over, and Congress shifting slightly back to policy rather than politics, the Home Care Alliance is ramping up advocacy on an important piece of new legislation regarding CMS’ Pre-Claim Review Demonstration.

The Pre-Claim Undermines Seniors’ Health (PUSH) Act (H.R. 6226) offers relief from the demonstration, which has already created a chaotic and expensive mess in Illinois. Providers in that state initially experienced 60-80 percent denial rates and continue to struggle with “partial claim denials” that the Center for Medicare and Medicaid Services (CMS) does not count or recognizeU.S. Capitol Building. Pre-Claim Review also features a time-consuming new paperwork burden, an inefficient electronic system that cannot process documentation, and physician unfamiliarity with what is needed to be compliant due to poor education from CMS. These reasons have led to considerable cash flow problems at agencies, and at least one Illinois agency has closed its doors for good.

Massachusetts and three other states could soon be subject to the burdensome program if Congress does not act.

Please take a few minutes and send a message to your US representative urging repeal of the Pre-Claim Review Demonstration, sponsored by Rep. James P McGovern (D-MA) and Rep. Tom Price (R-GA). It only takes a minute to advocate and gaining support through congressional “co-sponsors” is critical.

Return to www.thinkhomecare.org.

 


Educational Calendar Updates

November 15, 2016

As you probably know, the Home Care Alliance of MA is constantly adding new programs in our calendar, especially with all that is changes in our industry. Please see below some new (and old) programs that we have to offer over the next few weeks:

Thursday, November 17th: “Coping with Chaos: Compliance Climate 2016”

Home Health and Hospice agencies must continue to navigate a chaotic environment with no end in sight.  Get clarity on what the government enforcement agencies and contractors are focusing on in 2016-2017.  Learn how to formalize processes and systems to capture key payment and clinical documentation concerns to avoid overpayment requirements and disclosures, including use of PEPPER data.  Understand how to approach communications and requests from the MACs, ZPICS, the OIG and the DOJ. Finally, take control of your agency’s health and survival by committing to a sound ethics and compliance program framework and evolving ethics and compliance activities.

 *NEW*Tuesday, November 29th: “Medicare B Home Nurse Practitioner Program”

Certain outpatient therapy and other Medicare services may be furnished by a home health agency (HHA) to individuals who are not homebound or otherwise are not receiving services under a home health plan of care (POC) using Medicare Part B billing. As of January 1, 2016, Medicare expanded this list to include advance care planning as a billable service provided by either a physician or a nurse practitioners.  Hear how one agency has developed and successfully used Part B Billing to expand the scope of their community services.

 *NEW*Wednesday, November 30th,, and Wednesday, December 7th: “Riding the Wave: OASIS C-2 Changes”
Oasis-C-2 is just over a month away; are your clinicians aware of all the changes? Come join the HCA for training on the structure and content changes in the OASIS-C2 data set that are effective January 1, 2017. These new items can impact your quality scores and re-imbursement; so be sure your clinicians are familiar with the changes.

*Western MA date and location TBD*

 *DATE CHANGE*Monday, December 5th: “The Gold Standard: Understanding the Background and Importance of Compression for Wound Care Patients”

Compression plays a vital role in both wound healing and reduction of wound recurrence.  Participants will increase their understanding of lower extremity ulcer presentation, compression types, options, dosage and how each can ultimately impact success and outcomes. In the home health arena, it is vital to clearly understand current options available to maximize clinical effectiveness and cost-efficiency.

 Tuesday, December 6th: “Financial Management Conference” *NOTE AGENDA ADDITION: Medicare PPS Changes for 2017*

Agency CFOs and CEOs will be well served by joining HCA on December 6 in Norwood for the Annual Financial Managers Conference. This year’s event features a stellar line-up of expert panels including speakers on Value-Based Purchasing, Revenue Cycle Management, Bundled Payments, and HIPAA/ Cyber Security

 Thursday, December 8th: “The Aide’s Role in Understanding Mental Health Disorders”

This presentation will explore some mental health disorders that may create challenges for the Nurse Aide in the home setting. According to the National Alliance on Mental Illness approximately 43.8 million adults or 1 in 5 adults in the U.S experiences mental illness annually.  Chances are that some of the patients we care for in the home may be experiencing some sort of mental illness.  Learn strategies that can help you when caring for these patients.

 *NEW*Tuesday, December 13th: “A Team Approach to Medication Management”

It takes the entire home health team working together to ad- dress this vital aspect of health care to make a difference and improve the quality of care for those we serve every day. This 90-minute webinar is devoted to promoting a Team Approach to Medication Management in home health.

 

To learn more about any of our programs go to our calendar:  http://www.thinkhomecare.org/events


We’ve Moved!

November 1, 2016

Did you hear? The Alliance has moved!

kneeland Our new location is in Chinatown, just a few minutes walk from South Station. Our address is:

Home Care Alliance of Massachusetts
75 Kneeland St., Ste. 709
Boston, MA 02111

Return to www.thinkhomecare.org.


2016-2017 Aides Teleconference Series Upcoming Schedule

October 3, 2016

Every month the Home Care Alliance of Ma shares the opportunity for Aides to gain their education hours needed by promoting teleconferences put on by the North Carolina Association. Why Participate? An investment in staff education is an investment in quality customer service for all types of agencies. For home health and hospice agencies, these hour-long teleconferences can be used to help meet the 12 hours per year educational requirements under the Medicare Conditions of Participation. For all providers, an educational investment in your staff pays off in quality care!

See below for the upcoming teleconferences available for purchase:

October 13, 2016
TOPIC: No Tricks & No Treats – What Aides Need to Know to Protect Themselves from Negative Accusations & Investigations
Speaker: Sherry Thomas, BSN, MPH
Description: It’s no treat to be investigated by the Federal Office of Inspector General (OIG) … scary sounding…yes? Have you ever heard of the OIG Exclusions List? That is a list you do not want to be on!! Are you aware that federal regulations can prohibit you ever working again in an agency such as a certified home health, hospice, Personal Care Services or a waiver program for seniors that receive federal funding like Medicare and Medicaid? Come join me as we talk about how you can land on this list and an aide’s responsibility to be above reproach. Don’t let the words fraud, abuse, neglect, misappropriation of property or drugs come near your good name. Handouts will include an Aide’s Code of Ethics!

November 10, 2016
TOPIC: The Aide’s Role in Patient Centered Care
Speaker: Kathie Smith, RN
Description: Patient Centered Care focuses on the patient as an individual and takes into account the individual person’s likes, dislikes and what makes for a “good day” along with the tasks necessary to carry out the assigned plan of care. This teleconference will focus on how to see the patient as a unique individual in providing patient centered care.

December 8, 2016
TOPIC: The Aide’s Role in Understanding Mental Health Disorders
Speaker: Cindy Morgan, RN, MSN, CHC, CHPN
Description: This presentation will explore some mental health disorders that may create challenges for the Nurse Aide in the home setting. According to the National Alliance on Mental Illness approximately 43.8 million adults or 1 in 5 adults in the U.S experiences mental illness annually. Chances are that some of the patients we care for in the home may be experiencing some sort of mental illness. Learn strategies that can help you when caring for these patients.

January 12, 2017
TOPIC: Who Can Sleep Tight…When Bed Bugs Bite!
Speaker: Kathie Smith, RN
Description: Bed bugs have been common in U.S. history. Although bed bug populations dropped dramatically during the mid-20th century, the United States is one of many countries now experiencing an alarming resurgence in the population of bed bugs. According to the US Environmental Protection Agency bed bugs are a public health pest. While bed bugs have not been shown to transmit disease, they do cause a variety of negative physical health, mental health and economic consequences. This teleconference will cover the negative effects of bed bugs, how to identify bed bugs and tips in preventing and treating bed bugs.

February 9, 2017
TOPIC: The Aide’s Role in Working with the Immobile Patient
Speaker: John Conrad
Description: Immobility and long periods of inactivity are harmful to elderly patients and can lead to a further loss of ambulation and strength as well as the increased risk of falls. Patients suffering a loss of mobility can also become depressed. Immobility can impact and cause serious health complications – including blood clots, urinary tract infection and respiratory complications. In-home aides play a vital role in helping to increase/maintain patient mobility and in preventing serious negative impacts.

March 9, 2017
TOPIC: The Aide’s Role in Confidentiality and HIPAA
Speaker: Michelle White, MSN, RN
Description: This workshop will focus on assisting your In-Home Aides in understanding HIPAA and confidentiality guidelines. This workshop will offer practical tips to ensure that the para-professional adheres to the required privacy standards. Also included: the impact of social media such as Facebook, My Space, YouTube and cell phones, text messages, etc.

April 13, 2017
TOPIC: The Aide’s Role in Working with a Terminal Client & Their Family
Speaker: Cindy Morgan, RN, MSN, CHC, CHPN
Description: What does it mean to be terminally ill? This presentation will define terminally ill as well as some of the different aspects of care that are so important to the patients and families facing a terminal illness. Learn about the trajectory of terminal illness and what to expect when the patient is nearing the end of life.

May 11, 2017
TOPIC: The Aide’s Role in Infection Control in Home Care & Hospice
Speaker: Michelle White, MSN, RN
Description: This workshop will focus on understanding the basic principles of infection prevention and control. This workshop will also focus on Blood Borne Pathogens and the principles surrounding transmission and methods in which the aide can protect themselves and the patient.

June 8, 2017
TOPIC: Eagle Eye Aides – Recognizing Key Patient Abnormalities
Speaker: Sherry Thomas, BSN, MPH
Description: You are in the first line of patient defense! You are the boots on the ground as far as helping to identify that something is “wrong” with your patient. You are the Eagle Eye Aide! Join this teleconference to learn how to recognize the subtle and not so subtle changes in your patient that is the first clue that something is amiss patient wise and what then to report to your supervisor!

Click Here to go to our Events Calendar to register for one or more of these great programs!


CMS to Delay Expansion of Pre-Claim Review Demo

September 20, 2016

CMS announced yesterday afternoon that they are delaying the expansion of the Pre-Claim Review Demonstration for Home Health Services which began in Illinois on August 3, 2016.

According a notice on CMS’s website, based on early information from the problems encountered in Illinois, CMS believes additional education efforts will be helpful before expansion of the demonstration to other states; therefore, they will not move forward with initiating the demonstration in Florida in October.  This education effort will focus on how to submit pre-claim review requests, documentation requirements, and common reasons for non-affirmation.

According to the notice, CMS views these efforts as crucial to the long-term success of the demonstration for beneficiaries, providers, and the Medicare program. CMS will therefore take additional time prior to expanding to other states.   The start dates for Florida, Texas, Michigan, and Massachusetts have not been announced; however, CMS will provide at least 30 days’ notice on this website prior to beginning in any state.  CMS continues to expect a staggered start, beginning with Florida.

The Alliance has been working closely with the state associations in the other demonstration states and national home health groups to advocate for major changes to the project.  Building off of this short-term victory, HCA will continue those efforts and is also briefing our Congressional delegation on the issue. HCA will, of course, keep members informed of any changes in the demonstration.

Return to www.thinkhomecare.org.


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