Home Health & Hospice

Weekly roundup

Homecare Insider, June 20, 2016

Study: Home health cuts costs of CJR

The use of home health services after a major joint repair surgery results in cost-effective care for Medicare patients and lower readmission rates, according to data analysis released last week.

CMS in April launched a bundled payment system for joint replacements through the mandatory Comprehensive Care for Joint Replacement (CJR) model in 67 regions. The CJR initiative examines the distribution of discharges for hospital patients to various postacute care settings, average Medicare payment per episode by first setting, and average readmission rate for related conditions within the CJR model.

The CJR analysis, released by the Alliance for Home Health Quality and Innovation, shows that when hospitals discharge patients to home health as the first postacute setting, they have lower Medicare episode payments and lower readmission rates than facility-based settings. Across all settings, 8% of episodes included in the data contain a readmission, while the average readmission rate for home health agency episodes was 5%. Readmission rates range between 12% to 15% for patients receiving rehabilitation in facility-based settings, according to the analysis.

Source: Home Health Care News

CMS releases FAQs for pre-claim review

CMS says the impending pre-claim review pilot program, announced last week and slated for phase-in starting in August, is not a prior authorization pilot, as was previously indicated in a proposed rule. 

On a FAQ posting on its website last week, CMS says timing is the major differentiator. “For prior authorization, a request must be submitted prior to services beginning and providers should wait until they have a decision before they begin providing services. With a pre-claim review, services have already begun and the request is submitted after all of the initial assessments and intake procedures are completed and services have begun. The pre-claim review occurs after services start but prior to the final claim being submitted,” CMS states.

CMS asserts the demonstration should have “minimal effect” on beneficiaries because the pre-claim review occurs after services start, within 30 days of the first treatment. The pre-claim review request would be submitted after a Request for Anticipated Payment (RAP) is submitted and before the final claim is submitted for payment.

Source: CMS

Study: One size EOL expenditure does not fit all
Healthcare spending rises dramatically at the end of life, but does the rate of expenditures differ across the population? Spending patterns leading up to death have not been fully examined, so researchers sought to determine the trajectories of healthcare spending during these beneficiaries’ last year of life.

In the study, Matthew Allen Davis and colleagues applied a new methodology to administrative claims data for older Medicare beneficiaries who died in 2012. The study, posted on the HealthAffairs blog last week, identified four unique spending trajectories among decedents:
•    Almost 49% had high persistent spending, characterized by high initial spending that steadily increased throughout the last year of life.
•    29% had moderate persistent spending (moderately high spending followed by a dip, then an increase in the last four months of life.
•    A little more than 10% had a progressive spending pattern, in which spending started relatively low but increased steeply throughout the time period.
•    More than 12% percent had late-rise spending, with very low spending up to four months before death, followed by an exponential increase.

High spending throughout the full year before death was associated with having multiple chronic conditions but not any specific diseases. “These findings suggest that spending at the end of life is a marker of general spending patterns often set in motion long before death,” the researchers concluded.

Source: HealthAffairs

NY Alzheimer’s homecare agency offers ‘virtual’ spiritual care

ACS Home Care LLC, based in Northport, New York and servicing Nassau, Queens, Suffolk, and Westchester counties, is collaborating with HealthCare Chaplaincy Network (HCCN) to offer its clients a direct connection to professional healthcare chaplains who can help with the emotional and spiritual distress surrounding this disease and other illnesses.

Isolation, anxiety, and existential questions often accompany an Alzheimer’s diagnosis, both for the patient and family caregivers. Chat with a Chaplain enables patients and family members to confidentially speak to a professional multifaith chaplain via phone, email, or video chat. Clients can obtain emotional and spiritual support as well as submit prayer requests.

This is the first collaboration between a homecare agency and HCCN, and is staffed by HCCN’s professional multi-faith chaplains, according to an HCCN press release last week.

Source: PRWeb