In this twice-monthly newsletter, you will find policy developments, research, and 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.
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Moving Health Home Mentions
McKnights Home Care: Extend COVID-19 Public Health Emergency (PHE) Flexibilities Beyond Spring (11/15) - Moving Health Home urges lawmakers to extend the Acute Hospital Care at Home program and telehealth waivers for at least another two years. “By temporarily extending the AHCAH program, acute care at home programs will have the predictability they need to maintain patient access and it will allow for additional data collection to inform policymakers on important considerations to permanently expand access to home-based care,” a spokesman for Moving Health Home told McKnight’s Home Care Daily Pulse in a statement.
Agency for Healthcare Research and Quality: Consumer Assessment of Healthcare Providers and Systems (CAHPS) Home and Community Based Services (HCBS) Survey Database (11/15) - AHRQ requests the Office of Management and Budget (OMB) to reapprove Consumer Assessment of Healthcare Providers and Systems (CAHPS) Home and Community Based Services (HCBS) Survey Database. The CAHPS consists of data from the HCBS CAHPS Survey, which is the first cross-disability survey of home and community-based service beneficiaries’ experience receiving long-term services and supports. It is designed to facilitate comparisons across state Medicaid HCBS programs throughout the country that target adults with disabilities, e.g., including older adults, individuals with physical disabilities, persons with developmental or intellectual disabilities, those with acquired brain injury and persons with severe mental illness. Comments are due December 15, 2022.
Substance Abuse and Mental Health Services Administration (SAMHSA): National Guidelines for Child and Youth Behavioral Health Crisis Care (11/15) - SAMHSA released the National Guidelines for Child and Youth Behavioral Health Crisis Care, which offers best practices, implementation strategies, and practical guidance for the design and development of services that meet the needs of children, youth, and their families experiencing a behavioral health crisis. SAMHSA specifically highlights the importance of home- and community-based services (HCBS) in de-escaling behavioral health crisis in youth.
Centers for Medicare and Medicaid Services (CMS): CMS Care Compare To Offer More New Information On Home Health-Physician Relationships (11/14) - Care Compare – the all-in-one search tool for consumers seeking home health, hospice and other Medicare-reimbursed health care services – will now include new information on providers’ relationships with doctors and clinicians. According to CMS, the new update is meant to “provide additional information to support patients and caregivers as they make health care decisions.” The update, the agency noted, will also offer “information about clinicians who aren’t affiliated with a hospital but work in other types of health care facilities.” For additional coverage, see Home Health Care News.
CMS: Newly Released CMS Framework for Advancing Health Care in Rural, Tribal, and Geographically Isolated Communities (11/15) - CMS Office of Minority Health (CMS OMH) released multiple new resources on their rural health strategy and helping those that live in rural communities to achieve their optimal health. Specifically, CMS reviewed home health provisions and the importance of care in the home in its report Advancing Rural Health Equity.
Bloomberg Law: Biden Extends COVID-19 Public Health Emergency (PHE) (11/14) - The federal public health emergency for COVID-19 will be in effect for at least the next 60 days, with Department of Health and Human Services officials not yet signaling an end date. The Biden Administration has promised to give states 60 days’ notice when a decision is reached. This ensures the continuation of several COVID-19 waivers and flexibilities, including the Acute Hospital Care at Home Program, until April 2023.
Research and Polling
Journal of the American Medical Directors Association: After Hospital Discharge, Slow Home Health Care Initiation Increases Risk of Rehospitalization (11/15) - Patients discharged from the hospital are at a higher risk of rehospitalization if they experience a delay in postdischarge home health care initiation. The study shows the risk of a rehospitalization or emergency department (ED) visit jumps by 12 percent when patients wait more than two days for their at-home care to start. The study findings demonstrate the importance of eliminating delays in care initiation and that patient education should be an important part of that goal, since better-informed patients might be less likely to postpone or seek to avoid home care.
CHEST: Hospital-Level Care at Home for Patients with Acute Respiratory Disease: A Descriptive Analysis (11/11) - Home hospital (HH) is hospital-level substitutive care delivered at home for acutely ill patients who would traditionally be cared for in the hospital. Despite HH programs operating successfully for years, and scientific evidence of similar or better outcomes compared to bricks and mortar care, HH outcomes in the US for respiratory disease have not been evaluated. This study retrospectively evaluates prospectively collected data of patients and found that patients that used HH had less utilization. 96 percent of patients completed the full admission at home with no mortality in the respiratory group. The findings suggest HH is as safe and effective for patients with acute respiratory disease as for those with other acute general medical conditions. If scaled, it can generate significant high-value capacity for health systems and communities, with opportunities to advance the complexity of care delivered.
Home Health Care News: Despite Staffing Challenges, HCBS Interest Remains Strong Among Senior Living Providers (11/9) - A report conducted by LeadingAge and Ziegler Healthcare Investment Banking found that in the last year, HCBS offerings either stayed relatively flat or dipped among most of the largest nonprofit senior living providers. Of those senior living providers, 42 percent offered some sort of home- and community-based care. That could include home health care, home care, adult day care, continuing care at home (CCaH) programs and Programs for All-Inclusive Care for the Elderly (PACE).
News and Market Developments
Business Wire: Chamberlain University Launches Home Health Initiative with Grant from American Nurses Foundation (11/17) - Chamberlain University announced the launch of a home health specialty initiative with funds from a $1.2 million grant the American Nurses Foundation’s Reimagining Nursing Initiative (RN Initiative) awarded to Chamberlain in May for its Practice Ready. Specialty Focused model. Home health was chosen as the next specialty to address the dire need of staff in continuing care and home health. Chamberlain has formed a partnership with BrightStar Care to develop an online didactic course, Introduction to Continuing Health (ICH), to be used in Chamberlain’s nursing programs.
Home Health Care News: How One Provider Has Successfully Navigated Pediatric Home Health Care’s Challenges (11/16) - The home health business comes with plenty of challenges, especially when dealing with pediatric care. Labor issues, for instance, are exacerbated in pediatric home health care. At the same time, there is a dire need for these types of services. The Denver-based Solace Pediatric Home Healthcare is an example of a company that has triumphed despite those challenges. Over the last two years, in particular, the company has thrived by establishing strong continuity with patients and leveraging the right technology partners.Solace currently offers in-home, clinic-based and school-based pediatric services in Colorado, Texas, Arizona, Oregon, Washington, California and Wyoming. It provides occupational, physical and speech therapy services to children from birth to 21 years old.
Home Health Care News: At-Home Care Provider DispatchHealth Raises Over $330 Million In Latest Funding Round (11/15) - The in-home medical company DispatchHealth has raised more than $330 million in yet another funding round, according to the company. Overall, that brings its funding total to well over $700 million since it was founded in 2013. The equity raise was led by Optum Ventures, with support from current investors such as Humana, Oak HC/FT, Echo Health Ventures and Questa Capital. New investors included Adams Street Partners, the Olayan Group, Silicon Valley Bank, Pegasus Tech Ventures and Blue Shield of California.
McKnights Home Care: Home Care Needs to Care About Family Caregivers (11/15) - Home care providers should care about family caregivers and develop strategies to support them. At a Home Care Association of America (HCAOA) webinar, Anne Tumlinson, CEO of ATI Advisory, emphasizes that every home care agency needs a family caregiver strategy. Home care is the most intricately connected with the family and the family caregiver.
Business Journal: Cornerstone Caregiving Focuses on Care at Home (11/15) - Cornerstone Caregiving is expanding its home care options into the community. Based in Waco, Texas, the company provides services such as cooking, cleaning, personal hygiene assistance and helping with hospice. Cornerstone Caregiving does not accept the Medicaid waiver. It does take private pay, VA pension, long-term care insurance and will take VA insurance once approved.
AARP Public Policy Institute (PPI): High-Performance Revisited: Examining Long-Term Services and Supports System Performance (11/14) - AARP announced it will update its LTSS State Scorecard for 2023 to adapt to current times and make necessary changes to better reflect AARP’s understanding of what drives a high-performing LTSS system. AARP launched the scorecard in 2011 to measure state long-term care support services and rank states in comparison to one another. The nonprofit said the scorecard has driven and highlighted change in LTSS systems over the years, as well as improved services and supports for older adults and people with disabilities. However, the aging population, shifting demographics and workforce challenges prompted AARP to revisit the scorecard.
PR Newswire: BioT Medical and NTT DATA Announce Strategic Agreement to make Hospital Care at Home a Reality (11/14) - BioT Medical, a company providing a validated cloud-native platform for building new care models based on Internet of Medical Things (IoMT) medical devices, announced a strategic agreement with NTT DATA, a digital business and IT services provider. The partnership enables health systems to overcome the six primary challenges associated with a Hospital at Home service: clinical, regulatory, financial, staffing, social and technological. NTT DATA's patient and provider experience capabilities combined with BioT's NoCode capabilities to integrate and easily manage any medical device or sensor generate a complete solution covering the six challenges from all angles. The platform allows for unprecedented quality of care to patients, at minimal burden to clinicians, and addresses the required cyber, privacy, and quality regulations for medical devices.
AJMC: Further Research Needed for Technology Use in Home Health (11/12) - The use of technology to assess older adults in the home setting is still in its infancy, with more research required to improve these innovations and determine when and how best to use them for these patient populations. Dr. Melissa O'Connor, a professor in community and home health nursing at Villanova University, and director of Gerontology Interest Group highlights that there needs to be more research on home health care technology.
Home Care Magazine: A Model for Optimizing Family Health & Care Team Collaboration (11/11) - For patients with Alzheimer's disease, functional challenges such as difficulties with bathing, feeding and mobility can be significant drivers of morbidity and mortality. In fact, fainting due to dehydration, falls and other forms of accidental trauma are reported to be the leading cause of hospitalization in Alzheimer’s patients—even though they are often preventable. Opportunities to support these patients and their family caregivers in their home environments stand to improve outcomes and reduce total cost of care.
McKnights Home Care: With Home Health Unveiled, All Eyes are on Home Health Value-Based Purchasing (HHVBP) (11/11) - There is much anticipation for the HHVBP model, which is based on how well an organization ranks compared to its peers. Under the expanded initiative, home health agencies receive adjustments to their Medicare fee-for-service payments based on their performance against a set of three quality measures relative to their peers’ performance: Data from Outcome and Assessment Information Set (OASIS), completed Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) surveys and claims-based measures.
Healthline: At-Home Blood Tests Are Becoming a Trend. What It Means for Health Care (11/11) - While at-home diagnostic testing is not new, a handful of testing companies have taken it one step further. Some diagnostic testing companies are now offering in-home appointments that include a blood draw. This trend in health care could help reduce barriers to care and lead to better diagnoses and management of health conditions. It can also be a convenient and potentially lower-cost alternative to testing in a clinical setting.
The New York Times: Can New Technology Make Home Dialysis a More Realistic Option? (11/10) - The Tablo System promises to make dialysis easier and more convenient for patients. But there are significant barriers to the technology. Training is required for all home dialysis candidates and the person helping them, and the company or home health agency usually visits the home during the initial period. The Food and Drug Administration (FDA) encourages a care partner while using Tablo, which can become a potential barrier for patients wanting to switch to home dialysis.
Mobi Health News: Home Care Company Sprinter Health Partners with Virtual Care Provider Firefly Health (11/10) - Sprinter Health announced its partnership with Firefly Health to integrate its home clinical services into Firefly's virtual primary care. Firefly's members will be able to receive lab draws, vital checks, electrocardiograms, and diabetic eye exams and food screenings at home through Sprinter's phlebotomists and nurses. Firefly physicians will receive the lab results and notes electronically for review.
Business Wire: Current Health Makes Its End-to-End Care-at-Home Platform Available in the Epic App Market (11/10) - Current Health announced that it has joined Epic’s App Market as an Orchard App, providing a turnkey way for Epic users to access Current Health’s care-at-home platform directly from Epic’s inpatient and outpatient electronic health record (EHR). The integration streamlines the implementation of clinical workflows, communication and data exchange, leveraging new Current Health modules for delivering cutting-edge, device-enabled hospital-at-home, post-acute and chronic condition management programs.
PR Newswire: NeueHealth and Medical Home Network Partner to Reduce Health Care Disparities through New ACO REACH Model (11/9) - NeueHealth Partners Community ACO, a partnership between NeueHealth and Medical Home Network, has been provisionally accepted to participate in the ACO REACH model starting January 1, 2023. The NeueHealth Partners Community ACO expands on two NeueHealth owned and managed Direct Contracting Entities (DCEs) that are transitioning to the ACO REACH model next year, which served approximately 47,000 Medicare beneficiaries as of the Second Quarter 2022.
Philips: The Smart Hospital of the Future is a Hospital Without Walls (11/7) - As health care becomes increasingly digitalized, much of the care that is delivered in hospitals today will move into the home and the community. At the same time, hospitals will continue to play a key role in the distributed health care system of the future, serving both as a central physical hub and as an orchestrator of a wider ecosystem of care. Philips published a position paper, which charts a smart hospital.
Mertz Taggart: Q3 2022 Home Health, Hospice and Home Care M&A Update (11/7) - The final home health rule could revitalize moribund mergers and acquisition activity in the home health sector in the final months of 2022. Mertz Taggart reported 23 total deals in this year’s third quarter, less than half of the 52 deals reported during the same period last year. The 77 deals so far this year are 40 percent fewer than the 123 reported during the first nine months of 2021. Hospice and home care also scored half as many deals in the third quarter compared to the previous year. Mertz noted that home care could continue to be a laggard if inflation continues to make it difficult for consumers to pay out of pocket for personal care services. For additional coverage, see McKnights Home Care.
Home Health Care News: VillageMD Inks Deal To Acquire Summit Health-CityMD In $8.9B Deal (11/7) - With investments from Walgreens Boots Alliance Inc. and Evernorth – Cigna Corporation’s health services organization, VillageMD will acquire Summit Health-CityMD. Upon completion of the transaction, VillageMD and Summit Health-CityMD will be a multi-payer platform and combined will have more than 680 provider locations in 26 markets. This deal will allow the ability to incorporate a multi-specialty model of care in the home. For additional coverage, see Home Health Care News.
Orlando Health: Hospital Care at Home (11/7) - Orlando Health Hospital Care at Home launches in February 2023. The program will be available to Orlando Health patients who meet specific clinical criteria determined by emergency department and hospital staff. Medical conditions that can be cared for safely in a home-based program. The Orlando Health program is the first in Central Florida to be approved by Centers for Medicare and Medicaid Services. It is an expansion of a federal initiative created during the height of the COVID-19 pandemic to increase hospital capacity and maximize resources.
McKnights Senior Living: Improving Quality Care by Small Assisted Living Providers is Goal of New Workgroup (11/7) - Maryland has assembled a workgroup to look at improving the quality of care and services offered in smaller communities. House Bill 636 requires the Maryland Health Care Commission to conduct a study on the quality of care provided by smaller assisted living programs. The goal of the study is to identify where care quality can be improved, trends related to inspection data or regulatory requirements, and the feasibility of an emergency reporting system. The study also will review assisted living licensure regulations to determine whether the programs receive sufficient reimbursement to cover the cost of care and whether home- and community-based waivers can be used for assisted living programs. The workgroup is expected to deliver its study report and recommendations to the state legislature by October 2023.
Baxter: Baxter Highlights New Home Dialysis and HDx Therapy Data in 14 Clinical Presentations at Kidney Week 2022 (11/7) - Baxter International Inc. presented 14 new data presentations about the role innovation plays in increasing access to and quality of home dialysis and expanded hemodialysis (HDx) care at Kidney Week 2022. One study found significant reduction in all-cause mortality and fluid balance, and cardiovascular and metabolic related adverse events, in home automated peritoneal dialysis (APD) patients with Sharesource remote patient management (RPM) versus APD patients without RPM.
Home Health Care News: Wages Up, Turnover Down in Home-Based Care (11/7) - According to the latest Home Care Salary & Benefits report from Hospital & Healthcare Compensation service, hourly pay rates for licensed practical nurses (LPNs) at home health agencies increased nearly ten percent from 2021 to 2022, while turnover rates fell slightly from last year. The latest report is based on responses from more than 860 home health agencies across the U.S. Wages have steadily increased in home health care since the onset of the COVID-19 pandemic.