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 email@example.com for future inclusion in this newsletter.
Check out our website and Twitter using the links below
Center for Medicare and Medicaid Services (CMS) Released the Proposed Medicare Physician Fee Schedule (PFS), Including Care in the Home Related Provisions(7/13) -CMS issued the proposed Medicare PFS for Calendar Year (CY) 2022, including home-based provisions. The public comment period will end on September 13, 2021. Notably, the proposed rule does not include any further action on Evaluation and Management (“E/M”) codes used for home visits. Moving Health Home's hope for the CY 2022 PFS was a reversal or lessening of the downward adjustments made in last year’s PFS, a nearly 10 percent cut to domiciliary/home visits. CMS did not recognize the high value of domiciliary visits and home visits E/M codes in the same manner as other facility-based E/M codes and the cuts remain in place. Other notable home care provisions include:
Telehealth Provisions, Including Allowing Home as an Originating Site for Mental Health Services;
Provisions Related to Administering Vaccinations in the Home; and
Clinical Laboratory Fee Provisions Related to Laboratory Specimen Collection and Travel Allowance for Homebound Patients.
CMS Announced Director of Center for Medicare(7/6) - Dr. Meena Seshamani, M.D., Ph.D. will serve as Deputy Administrator and Director of Center for Medicare (CM). Dr. Seshamani will lead the Center’s efforts in serving the people 65 or older, people with disabilities, and people with End-Stage Renal Disease that rely on Medicare coverage. This selection of leadership is important to Moving Health Home because CM is a critical office for any regulatory goals around care in the home. Dr. Seshamani started July 6.
Senate Special Committee on Aging Ranking Member Scott Sent Letter on Home and Community-Based Services to CMS (7/7) - Ranking Member Scott (R-SC) sent a letter to CMS Administrator Brooks-LaSure calling for improving quality and combating fraud in Medicaid’s home and community-based services. In the letter, Senator Scott notes that most older Americans prefer to stay at home as they age, and asks CMS to describe its efforts to establish quality measures for Medicaid home and community-based services and mitigate fraud to ensure all Americans are afforded the right to age where they prefer with dignity, respect, and quality care.
Research and Polling
Global Coalition on Aging and Home Instead:Building the Caregiving Workforce Our Aging World Needs (7/7) -A new report examines the current state of the global caregiving workforce. Authors explain that it is important to not only paint a picture that is compelling as to why we need to transform the caregiving profession around the world, but they also provide very specific recommendations on the next steps to continue the conversation. “This is an ongoing journey of progress across the industry, at Home Instead and with home care providers everywhere," Jisella Dolan, chief advocacy officer at Home Instead Senior Care, told Home Health Care News.
News and Market Developments
Health Payer Intelligence: Payer Moves to Increase Member Access to Acute Home Healthcare (7/16) - Regence BlueShield (Regence) has partnered with a home healthcare provider to increase member access to acute home healthcare services. Regence members in Pierce County, Washington will have access to the new program. The payer plans to expand the acute home healthcare service to other counties in the state this year. “‘Hospitalizations in the home’ is a groundbreaking and exciting shift in care delivery,” Drew Oliveira, MD, senior executive medical director at Regence BlueShield, said in the press release. “Our partnership with DispatchHealth enables Regence members to receive clinically appropriate care safely and conveniently in the comfort of their own homes.”
Home Health Care News: Aegis, Fox Rehabilitation See Increased Demand for In-Home Therapy Services (7/13) - “A patient may have low physical therapy needs but high occupational therapy needs, for example, so it’s really important to look at a patient from a comprehensive care plan perspective,” Dawn Greaves, vice president of home services at Aegis said. Fox Rehabilitation — a therapy provider that specializes in “geriatric house calls” — has found that working in the home has achieved the best outcomes for patients. They have seen a 36% functional scale improvement in patients and a 97% patient satisfaction rating.
Home Health Care News: Changemakers: Susan Diamond, CFO, Humana (7/12) - In an interview, Susan Diamond commented on the shift towards more high-acuity services in the home and Humana's work with DispatchHealth. On the reason for the shift, she said: "Skilled nursing facilities have taken the largest hits through the pandemic...That, in my mind, accelerated the introduction of those types of models by years, compared to what we might have seen in the absence of a pandemic. That’s important for us, considering we made our investment in DispatchHealth long before the pandemic. They’ve been really successful and have been expanding their services, demonstrating the level of care that can be brought into the home. They’ve demonstrated quality outcomes, reduced readmissions and more."
Home Health Care News: Resilient Healthcare Blazing New Trails for Hospital-at-Home Model (7/11) - Currently, Resilient serves upwards of 100 patients in Texas, with a staff of over 40 full-time employees and more than 130 clinicians from a wide range of disciplines. It has received especially high interest in its hospital-at-home model as of late, though, partly thanks to the CMS “Acute Hospital Care at Home” waiver unveiled in November. CMS signing off on hospital-at-home care has pushed more insurance companies toward innovative virtual and mobile health systems. “It gives insurance companies the confidence to say, ‘Oh, well, Medicare gave them a revenue stream for this. It makes sense that we follow suit,’” Jaky Samuel said.
mHealth Intelligence:UMass Memorial Eyes Telehealth, RPM Benefits in New Hospital at Home Program(7/9) – UMass Memorial Health is partnering with Current Health and joining the Hospital at Home movement. The new program will integrate remote patient monitoring and telehealth strategies with in-person visits to provide care management at home for patients who would otherwise be taking up a hospital bed.
McKnight's Senior Living: Move toward home-based care 'now inevitable,' DispathHealth CEO says (7/7) - Roughly 100 million people in 18 states now have access to DispatchHealth’s roving teams of nurse practitioners and medical technicians. It is part of the rapidly expanding U.S. house call sector that includes VillageMD, Heal, and Doctor On Demand. Grand View Research values the sector at $460 million and projects it will expand at a compounded annual growth rate of 5% over the next six years. DispatchHealth is among the sector’s largest and has relationships with most health insurance companies, as well as numerous health systems.
Home Health Care News: Recent Deals Signal Start of a New Home Health Arms Race, Market Shift (7/8) - Reinforced by this week’s deals, it’s clear that “higher-acuity care in the home” has become a must-have capability, particularly for the larger home-based care companies. To best capitalize on post-COVID tailwinds and the changing needs of referral partners, providers want to be able to take charge on hospital-at-home, SNF-at-home and LTACH-at-home models.
OncLive: In-Home Infusions Could Continue to Bridge Disparities in Cancer Care (7/8) - In 2021, CTCA announced that they were partnering with Coram, CVS Health’s infusion care business, to deliver in-home chemotherapy infusions to eligible patients. Currently, the pilot program is enrolling Atlanta-based patients with a range of diseases, including breast, lung, prostate, colorectal, head and neck, and some genitourinary cancers, but is planned for expansion to other parts of the United States. Once patients have an inpatient infusion and they are deemed appropriate to move into the home, they can be enrolled in the program. It is often in the maintenance phase that patients are eligible.
D Magazine: In North Texas, Care is Moving From the Hospital to the Home (7/8) - This article covers the changes in health care delivery in the Dallas area as hospital-at-home programs pick up in popularity and prove their worth. It makes the point that as CMS is continuing to force providers toward value-based care over fee-for-service, the hospital-at-home model is a perfect fit as it rewards providers who can care for their patients efficiently. It highlights the successes of a Johns Hopkins pilot that has shown to reduce costs by 19 to 30 percent without losing quality.
Elizabeth Fowler, JD, PhD, CMMI Director and CMS Deputy Administrator is among the keynote speakers and has publicly stated moving health into the home as a CMMI topic of interest and exploration. Early bird registration rates expire on Friday, July 23.
NASHP’s 34th Annual State Health Policy Conference: State Health Policy Unmuted(September 21-22) - Join hundreds of state leaders, from all 50 states and DC, as NASHP discusses the timely, cutting-edge issues facing state health policymakers, and highlights innovative solutions shared by the nation’s leading experts on topics including: lowering Rx costs, hospital costs, Medicaid, health insurance marketplaces, telehealth, social determinants of health, behavioral health, and more. This is a great opportunity to get a pulse on state priorities and opportunities to promote moving health into the home, especially as states grapple with improving health equity and lowering costs. Early bird registration rates expire on Friday, August 27.
Virtual Hospital at Home User Group Annual Meeting(October 28) - As a pre-conference to the American Academy of Home Care Medicine’s meeting, the User Group will be hosting a day-long meeting that will include presentations from national leaders, panel discussions, and working sessions focused on practice and policy concerns, as well as a poster session, a photo/video contest, and much more.
American Academy of Home Care Medicine Virtual Annual Meeting(October 29-30) - At their annual meeting, you will have the opportunity to explore innovative models of care, learn evidence-based best practices, discover new strategies to improve care coordination through interdisciplinary care, and acquire the skill set to implement rapid performance improvement at this year’s conference. Example sessions include:
SNF at Home: Successes and Challenges of Launching a Home-based Post-Acute Care Program. This session will focus on describing successes, challenges, and lessons learned involved with launching a SNF-at-Home program.
Home-based Medical Care: Evolving from Fee for Service to Global Risk. Such models in the US have struggled because of the inability to have a sustainable business model in a fee-for-service payment system, in particular, Medicare fee-for-service. In this session, we discuss the conditions needed to allow a home-based medical care model to thrive and grow.