Home Health & Hospice

Weekly Roundup

Homecare Insider, January 4, 2016

CMS releases draft of OASIS C2

CMS has issued a draft of the Outcome and Assessment Information Set (OASIS) C2, aiming to standardize assessment data and quality measures in home health agencies. OASIS C2 is slated for implementation on January 1, 2017, in order to comply with requirements for post-acute care under the Improving Medicare Post-Acute Care Transformation Act of 2014.

Beginning January 1, 2017, home health agencies must begin reporting measures related to changes in skin integrity, medication reconciliation, and resource use. Key elements of OASIS C2 include:
•    Three new standardized items (M1028, M1060, and GG0170c) as well as modifications to and renumbering of some medication and integumentary items (M1311, M1313, M2001, M2003, and M2005) to standardize them with other post-acute care settings.
•    Changes to the required look-back period and item number for M1500, M1510, M2015, M2300, and M2400.
•    Document-wide formatting changes to simplify data entry where responses are mutually exclusive, and to change the numbering for pressure ulcer staging from Roman to Arabic numerals.

Source: CMS

Fortune forecasts jump in home health and hospice use

End-of-life care will grab headlines, and hospice usage will double among accountable care organizations and capitated doctors, according to prognosticators at the Fortune Insider website. In a recent blog post titled "10 Big Healthcare Predictions for 2016," Bob Kocher and Bryan Roberts predicted that, "in response to increasingly expensive medications, high deductible plans and new payment models, doctors [will] engage patients in the shared decision-making around end-of-life discussions." This will eventually put pressure on drug pricing, generate higher Net Promoter Scores from patients, and lead to higher incomes for physicians, according to Kocher and Roberts, who are partners with venture capital firm Venrock.

Source: Fortune

States ask high court to review protections for homecare workers

Following a legal battle that lasted more than two years, the U.S. Court of Appeals for the District of Columbia Circuit in August restored the Department of Labor’s rule guaranteeing overtime and minimum wage protections to roughly 2 million homecare workers nationwide. But that may not be the end of the story. Last week, a dozen states asked the U.S. Supreme Court to review the lower court’s decision, arguing that the ruling poses a financial burden to states and threatens residents’ access to in-home care.

Attorneys general from Arizona, Arkansas, Georgia, Kansas, Michigan, Nevada, North Dakota, Oklahoma, Texas, Utah, Wisconsin, and Wyoming issued a court brief asking the high court to reconsider the appellate court’s decision and recommending that homecare workers remain exempt from the Fair Labor Standards Act. According to the brief, the new rule is unreasonable because it doesn't address "the lack of adequate state funding of the increased costs of homecare under the new rule."

A recent survey by the National Employment Law Project found that homecare workers earned an average of $18,598 in 2013, and nearly half of all homecare workers live in households that receive public assistance benefits such as Medicaid, food stamps and housing and heating assistance.

Source: NAHC

Senate committee seeks comments on hospice, home health policy options

Last week, the U.S. Senate Finance Committee’s Bipartisan Chronic Care Working Group last week released a Policy Options paper that summarizes policy ideas to improve care coordination in the Medicare program. Among the policy changes under consideration is one that would extend hospice benefits to Medicare Advantage (MA) enrollees. Under current law, MA enrollees may opt for hospice care, but must either “disenroll” from MA or receive a combination of services from traditional Medicare and MA. “Both of these options lead to either a disruption in care or fragmented care delivery,” the working group noted. The policy would require MA plans to offer the full scope of the hospice benefit provided under traditional Medicare, including the required care team and written care plan.

If a policy change is made, the current MA payment system would need to be adjusted to accommodate this additional benefit. The MA five-star quality measurement system would also need to be modified to include measures associated with hospice care. Such additional quality measures would include, but not be limited to, health outcomes (including patient satisfaction) and appropriate level of care.

The working group is soliciting feedback on specific plan-level measures that could be used to ensure that MA hospice beneficiaries are receiving appropriate and high-quality care and is also soliciting feedback on other safeguards to ensure MA enrollees have access to high-quality hospice services. Comments and questions specific to the content in this document will be accepted through January 26, 2016.

Source: U.S. Senate Finance Committee