Home Health & Hospice

Weekly roundup

Homecare Insider, March 21, 2016

Analysis: No 'gotchas' for hospice in MedPAC report

Chapter 11 of the Medicare Payment Advisory Commission Report to the Congress: Medicare Payment Policy, March 2016 Edition, has no obvious causes of concern for hospice care, according to analysis by the Hospice Action Network. The chapter,which outlines Medicare payments for hospice services, mentions value-based purchasing models as well as MedPAC’s concerns regarding short stays and initiatives like the Medicare Care Choices Model.

The chapter provides a “fairly substantive” overview of recent developments on quality reporting within the hospice community, according to the analysis, which was posted last week on the Hospice Action Network website. According to the MedPAC report:

  • In 2014, nearly 48% of Medicare decedents used hospice, up slightly from 2013.
  • Patients with non-cancer diagnoses have been a driver of increased hospice use during the past decade.
  • The growth in average length of stay for the 90th percentile has slowed (only one day from 2012 to 2014).
  • The median length of stay in 2014 was 17 days.

Source: Hospice Action Network


Bill would offer a break to family homecare workers

A measure introduced to Congress earlier this month by Reps. Tom Reed (R-NY) and Linda Sanchez (D-CA), would reimburse caregivers’ out-of-pocket expenses incurred while caring for an aging or disabled relative. H.R.4708, the Credit for Caring Act of 2016, would allow deductions for expenses such as homecare, adult daycare, and respite care. It would allow family caregivers to claim up to $3,000 in tax credits for “qualified expenses” related to caregiving.

Among other things, these expenses include:

  • Assistance, supervision, and standby assistance
  • Assistive technologies and devices, including remote health monitoring
  • Environmental modifications, including home modifications
  • Health maintenance tasks (such as medication management)
  • Transportation of the qualified care recipient
  • Certain non-health items, such as incontinence supplies
  • Caregiver travel costs related to caring for a qualified care recipient, including mileage
  • Lost wages for unpaid time off due to caring for a qualified care recipient, as verified by an employer
  • Coordination of and services for people who live in their own home, a residential setting, or a nursing facility, as well as the cost of care in these or other locations

Source: Congress.gov, AARP


Arkansas lawmakers question home health privatization plan

As Arkansas moves to privatize its in-home healthcare services program, lawmakers last week voiced concerns that patients in rural areas will lose access to home health services, and the state employees of the program will be left behind as well.

The state program, started in 1981, offers hospice, home healthcare, personal care and other services to about 9,100 patients, most of whom pay for services through Medicare or Medicaid. Department of Health director Nathaniel Smith told lawmakers there are more than 100 in-home healthcare providers in the state, and he made the decision to sell the program after reviewing several years of information, the report stated.

The department sought proposals from private companies  and hopes to make the transition to a private provider this summer, said Smith. The savings to the state will depend on the ultimate price of the sale. Since the August announcement, about 200 of the 500 full-time state employees have left the program; about 1,500 of the contracted workers are still operating around the state, according to the department.

State employees who stay with the program until the time of the transition will receive an unspecified retention bonus. The bonus will be based on the proceeds of the sale of the program. In addition, a minimum requirement for the company that purchases the program will be to retain the state employees for a year.

Source: Arkansas Online


Medicare usage all over the map

The CMS Office of Minority Health last week unveiled a snapshot of chronic disease-related service usage nationwide by county. Chronic diseases pose a significant problem in the United States resulting in substantial morbidity, mortality, disability, and cost. The CMS Office of Minority Health has designed an interactive map, the Mapping Medicare Disparities (MMD) tool, that identifies areas of disparities among subgroups of Medicare beneficiaries (e.g., racial and ethnic groups) in health outcomes, utilization, and spending.

This information may be used to inform policy decisions and to target populations and geographies for potential interventions, according to CMS.

The Mapping Medicare Disparities (MMD) tool contains health outcome measures for disease prevalence, costs, and hospitalization for 18 chronic conditions, emergency department utilization, readmissions rates, mortality, and preventable hospitalizations. The MMD tool allows users to:

  1. View health outcome measures at a national, state, or county level
  2. Explore health outcome measures by age, race and ethnicity, and gender
  3. Compare local access against national averages
  4. Compare differences aong populations in the same geographic area. 

The MMD tool can be accessed here.

Source: CMS