Home Health & Hospice

Weekly Roundup

Homecare Insider, December 7, 2015

Quality measure overhaul coming to home health

The National Quality Forum (NQF) has announced its plan to review the standardized performance measures that the U.S. Department of Health and Human Services is considering for use in federal health programs. The review is done by the Measure Applications Partnership (MAP) and includes a hospital workgroup, clinician workgroup, and post-acute and long-term care workgroup that identify gaps in measurement across settings and prioritize the measures.

Of the measures under review, six would have a direct impact on the home health quality reporting system, two would affect the hospice quality reporting program and one would target oncology patients receiving hospice care.

Sources: NQF, Home Health Care News

 

Payment shifts on horizon with final payment rule

Editor's note: For full analysis of the final rule, view the December issue of Homecare DIRECTION. Not a subscriber? Learn more about Homecare DIRECTION and the Beacon Institute.

CMS' proposed home health PPS rule for calendar year (CY) 2016 and the final PPS rule, released October 29, had one thing in common: an attempt to diminish—but not eliminate—the impact that impending payment shifts will have on providers.

But these changes will likely do little to stanch the tide of open-ended payment initiatives that threaten to shutter agencies in the years ahead.

"It's a difficult thing right now to try to survive in the Medicare world of home health," says J'non Griffin, RN, MHA, WCC, HCD-10, COS-C, owner and senior consultant at Home Health Solutions, LLC, in Carbon Hill, Alabama.

Read more.
 

Understanding what CJR means for home health

The Centers for Medicare & Medicaid Services (CMS) final rule for bundled payment demonstration on hip and knee joint replacement will go into effect April 1, 2016. Under the Comprehensive Care Joint Replacement (CJR) Program, a single payment, made to a qualifying hospital (790 total) in one of 67 regions/metropolitan statistical areas, covers all aspects of the hospital care, surgery, and any post-discharge, post-acute-stay components through 90 days (from initial hospitalization).

Payment exclusions include unrelated hospital and Part B costs, unrelated acute and chronic DRGs, and drugs outside the episode (e.g., clotting factors, etc.).

The takeaway for post-acute providers is simple: Get lean, get good, and get partners, states post-acute care expert Reginald Hislop III, in Reg's Blog.

Sources: MDS Central, Reg's Blog, Leavitt Partners, CMS