In this twice-monthly newsletter, you will find updates on how health care organizations are striving to shift more health care delivery into the home – meeting patient needs where they are and expanding access to quality health care.
This newsletter recaps current events and research. Please send any news or events to firstname.lastname@example.org for future inclusion in this newsletter.
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MHH Submits Regulatory Comments on the
Proposed Medicare Physician Fee Schedule
"CMS must recognize the high value of domiciliary visits and home visits E/M codes in the same manner as other facility-based E/M codes. For our most frail and increasingly aging population, home-based cares services are needed now more than ever."
Centers for Medicare and Medicaid Services (CMS): The CMS Innovation Center Withdraws ET3 Notice of Funding Opportunity (9/13) - The Emergency Triage, Treat, and Transport (ET3) payment model aims to provide greater flexibility to ambulance care teams to address emergency health care needs of Medicare Fee-for-Service beneficiaries following a 911 call. Participating ambulance suppliers and providers will be able to collaborate with alternative destinations, such as primary care doctors’ offices or urgent-care clinics, to deliver treatment in place, which can be on the scene, including the home, or through telehealth.
On September 13, CMS announced it is withdrawing the funding opportunity for state and local governments to expand 911 medical triage line services in locations of model participants. CMS said this decision does not impact Participation Agreements with the 184 selected ambulance services – ET3 will move forward for those participants.
My First 100 Days and Where We Go From Here: A Strategic Vision for CMS (9/9) - CMS Administrator Brooks-LaSure penned a blog post highlighting actions during her first 100 days.In the blog, she writes: "CMS increased the availability of home-based community services so that seniors and people with disabilities can receive the care they need in their own homes and communities. This included increasing access to COVID-19 vaccinations to 1.6 million Medicare beneficiaries who have difficulty leaving their homes or are otherwise hard-to-reach."
Government Accountability Office (GAO): Medicaid Home- and Community-Based Services During COVID-19 (9/8) - The U.S. Government Accountability Office (GAO) issued a report on Medicaid home- and community-based services (HCBS), finding that CMS often relied on states to monitor HCBS programs during the COVID-19 public health emergency, and that CMS’ plan for evaluating the impact of temporary changes made in the wake of the PHE is unclear. GAO made two recommendations to CMS to:
Develop procedures to monitor temporary changes to HCBS programs during public health emergencies; and
Evaluate the temporary changes after the COVID-19 emergency and address opportunities for improvement.
House Committees Advanced Portions of the Build Back Better Act, Includes HCBS Investment (9/15) - On September 15, the House Energy & Commerce (E&C) Committee and House Ways & Means (W&M) Committee completed markups of their respective portions of the Build Back Better Act. House E&C advanced provisions related to HCBS, including a permanent seven percent increase in the federal match for HCBS, along with extra money for administrative costs and to boost programs that allow families to direct their own long-term care. Overall, the measure is an investment of $190 billion, which is short of the $400 billion requested by the Biden Administration. You can view the committees' press releases here: E&C and W&M.
Inside Health Policy: Senator Casey Says HCBS Should Be Required Benefit, In Addition to Investments (9/14) - Senator Bob Casey (D-PA) said at a University of Pittsburgh lecture Monday (September 13) that Medicaid law should be changed to require home- and community-based services across the country, as HCBS investments set to be included in Democrats’ reconciliation package won’t ensure the services are fully accessible to beneficiaries. Casey, chair of the Senate Special Committee on Aging, introduced a bill in June that would invest $400 billion in the Medicaid home care services and the workers who provide them.
Research and Polling
Bipartisan Policy Center (BPC): Bipartisan Solutions to Improve the Availability of Long-term Care (9/14) - BPC released a report with recommendations to make long-term services and supports (LTSS) more affordable for those who do not qualify for Medicaid. This report is part of their ongoing work around LTSS and Medicaid HCBS, including expanding Medicaid HCBS. Their recommendations to Congress focus on five key issue areas:
Expanding access to HCBS,
Addressing disparities in the delivery of HCBS,
Creating a caregiver tax credit,
Improving the viability of long-term care insurance, and
Establishing a public education campaign for long-term care.
HME News: The National Home Infusion Association (NHIA) To Publish Scholarly Journal for Infusion Therapies (9/13) - The NHIA will launch a new peer-review publication, Infusion Journal. The new scholarly journal will feature independent research and studies related to infused therapies, patient outcomes, medication safety, economic analyses, and case studies.
American Journal of Managed Care: Hospital at Home: Paying for What It's Worth (9/10) - Researchers from Harvard provide a framework for evaluating the value of hospital at home programs centered around cost, quality, and equity and then discuss how that should contribute to their appropriate reimbursement rates. They recommend that quality reporting should use both inpatient-specific and home health care–specific metrics, equity-focused process metrics and risk-adjusted outcome metrics, and validated disease-specific tools. Costs should be measured comprehensively and uniformly through the use of time-driven activity-based costing and consider caregiver opportunity costs. It is also worthwhile to consider personal, societal, technical, and allocative value when determining the value and subsequent reimbursement rates of hospital-at-home programs.
MHH Media Mentions
Home Health Care News: Amazon Care Reportedly Plans to Expand Its At-Home Care Services to 20 New Cities by End of 2022 (9/8) - Amazon Care’s model is based on both a virtual and physical approach, offering in-person visits from medical professionals and other digital services, which are all coordinated through an app. Currently, there are about 40,000 people enrolled in Amazon Care, according to the Insider report. As a flagship member of the Moving Health Home coalition — which vies for favorable legislation for home-based care on Capitol Hill — it’s clear that Amazon sees immense value in taking care of people in their own homes.
News and Market Developments
Fierce Healthcare: Clover Health, MedArrive Partner to Offer Home COVID Vaccinations to Members (9/16) - Clover's membership is focused in the senior market, both in Medicare Advantage and through care coordination services in traditional Medicare. As such, a number of its members are homebound and may struggle to get vaccinated, despite their high risk for complications related to the virus. These patients will now be able to get the COVID vaccine in their homes. The effort will kick off in New Jersey.
Valdosta Daily Times: Northwell Health and Walgreens Announce Strategic Agreement (9/16) - As part of the digital agreement, Northwell telehealth providers are now accessible on the Walgreens Find Care platform across the state of New York, expanding community member access to virtual emergency care services from board-certified emergency medicine physicians in the comfort of their home. Pediatric specialists are also available.
Harvard Business Review: How U.S. Employers Can Help Provide Better Health Care (9/15) -Large employers (those with more than 5,000 employees) have an opportunity to learn from their pandemic experiences to change how they pay for and manage the health of their populations. Originally developed for the elderly and Medicare population, home-based care — including house calls with lab draws and ER- and hospital-level care — has been expanded to working adults as well. Self-insured large employers should cover programs like this that have been proven to be cost-effective.
Fierce Healthcare: CareFirst Unveils New Virtual Primary Care Practice, CloseKnit (9/15) - CloseKnit will offer a slew of healthcare services in a virtual-first delivery model, including preventive care, urgent care, behavioral health care, care coordination and insurance navigation. Services are available through an app and are built to be affordable and transparently priced. In-person care is provided through referrals to local providers.
Newswise: Patients in Phoenix Area Now Can Benefit from Mayo Clinic's Advanced Care at Home Model of Care (9/15) - Mayo Clinic has expanded its advanced care at home model of care, which provides comprehensive care to patients in the comfort of their own homes, to Mayo Clinic in Arizona. Beginning this week, many patients in the Phoenix and Scottsdale area who otherwise would need to be hospitalized will be able to receive in-person and virtual care through Mayo Clinic's advanced care at home platform. Video coverage of the program can be found here.
Yahoo Finance: VeeMed Announces Plan to Change Name to VeeOne Health (9/15) - The name change follows the company’s evolution into providing a single telehealth platform to serve all the needs of healthcare systems across the entire continuum of care. This complete spectrum of care includes technology solutions for inpatient, outpatient clinical setting, remote patient monitoring (RPM), and hospital at home. It also provides operational support for customer service, credentialing, billing, and revenue cycle management.
Home Health Care News: 24 Hour Home Care Buys Non-Medical Division of Home Health 'Bundling Expert' GrandCare (9/15) - 24 Hour Home Care bought the non-medical caregiving division of GrandCare Health Services. Financial terms of the acquisition, effective Sept. 1, were not disclosed. GrandCare Health Services provides in-home medical care across Southern California with the bulk of their business historically being in skilled home health care, with a particular focus on orthopedic rehabilitation. Los Angeles-based 24 Hour Home Care exclusively provides non-medical home care services across its markets.
Home Health Care News: Older Americans Overwhelmingly Support Choose Home Care Act (9/14) - The Partnership for Quality Home Healthcare (PQHH) and the National Association for Home Care & Hospice (NAHC) highlighted the support for Choose Home Tuesday by sharing results of a new public opinion poll representing a national sample of 2,200 adults. Over nine in 10 of the Medicare beneficiaries who took part in the poll said they would prefer to receive post-hospital short-term health care at home. Just 3% said they would prefer post-hospital nursing home care.
Healio: Partnership Between HHS, ASN Has Power to 'Dramatically Change' Kidney Care (9/10) - KidneyX, a public-private partnership forged by HHS and the American Society of Nephrology, is uniquely poised to spur change in kidney care. These changes aim to encourage dialysis providers to decrease disparities in rates of home dialysis and kidney transplants among ESRD patients with lower socioeconomic status, making this the first model to directly address health equity.
Pharmacy Practice News: Hospital-at-Home Gains Traction (9/9) - Although multiple clinical benefits are ascribed to hospital-at-home care—including avoidance of hospital-acquired infections—challenges also exist. Donald Mashni, PharmD, the system director of the Mount Sinai Specialty Pharmacy, in New York City, outlined some pharmacy-specific issues that need to be addressed: labeling, documentation, storage and refrigeration, and patients' home medications.
Milbank Memorial Fund: Shift Toward Home-Based Care is Underway in Connecticut's Long-Term Services and Supports Program (9/7) - In a new article, Martha Hostetter and Sarah Klein describe how Connecticut leaders are using local data, a statewide strategic rebalancing plan, and a range of complementary programs — including a supportive housing program — to meet the needs of different types of residents who require help to live in the community. The authors also highlight lessons from Connecticut’s rebalancing efforts.
Home Health Care News: Humana Executive: Data, Analytics Key to a Home-Focused Health Care System (9/7) - Home health operators have been advocating for more care to be delivered in the home for years. Those calls have now come to fruition. In actuality, other health care stakeholders have sought to shift more care into the home as well, but operational hurdles and unavoidable gaps in care made that mission seemingly impossible. But now the home health industry is ready, Heather Cox, the chief digital health and analytics officer at Humana Inc. (NYSE: HUM), argued in a recent Boston Globe op-ed.