NHPCO and NAHC Announce Transition Board of Directors

NHPCO

The National Association for Home Care & Hospice (NAHC) and the National Hospice and Palliative Care Organization (NHPCO) jointly announced today that they have developed a proposed slate of Transition Board of Directors and officers for 2024. The Transition Board will oversee the transition to a new, consolidated organization pursuant to its ratification by both associations’ Boards of Directors in an agreement to combine which is contemplated in early 2024. The as-of-yet to be named organization will combine the strengths of NAHC and NHPCO, creating a better and more powerful advocate for the entire care-at-home community. This effort has been led by a joint Steering Committee, comprised of member and staff leaders from NAHC and NHPCO, which has been working collaboratively towards the shared goal of enhanced collaboration to drive industry impact, member value and quality patient outcomes.

The proposed Transition Board was selected collaboratively by the boards of NAHC and NHPCO and represents the full breadth of the patient-centered healthcare sector providing care in homes and communities nationwide, with wide-ranging expertise, demographic and geographic diversity, varied organizational tax statuses, and other criteria. The Transition Board includes equal representation from NAHC and NHPCO — directors with deep experience in home health, hospice, palliative care, personal care services, home care, and private duty. The board also includes business partners, representatives from state associations and at-large members. The board and officers will be ratified when the Definitive Agreements are signed in early 2024.

The proposed Transition Board is as follows:

  • Ken Albert, R.N., Esq., Androscoggin Home Healthcare + Hospice, NAHC, Transition Board Chair
  • David Causby, Gentiva, NAHC
  • Trisha Crissman, MA, CommonSpirit Health at Home, NHPCO
  • Melinda Gruber, PhD, MBA, CNA, Corewell Health, NHPCO, Transition Board Vice Chair
  • Demetress Harrell, MA, LBSW, DAPA, Hospice in the Pines, NHPCO
  • Susan D. Lloyd, MSN, RN, Delaware Hospice, Inc., NHPCO
  • Tarrah Lowry, Trustbridge / Empath, NHPCO
  • Christine McMichael, MA, Hospice & Palliative Care Federation of Massachusetts, current chair of Council of States, NHPCO
  • Mark Morse, Enclara Pharmacia, NHPCO
  • Mary Myers, Retired Johns Hopkins, NAHC
  • John Olajide, Axxess, NAHC
  • Bob Parker, DNP, RN, CENP, CHPN, CHP, Kindful Health, NHPCO
  • Susan Ponder-Stansel, Alivia Care, Inc., NAHC
  • Sara Ratcliffe, Illinois HomeCare & Hospice Council, current chair of Forum of States, NAHC
  • Lynne Sexten, FACHE, Agrace, NHPCO, Transition Board Secretary
  • William Simione, SimiTree, NAHC, Transition Board Treasurer
  • Jennifer Sheets, NAHC
  • Beth Slepian, Granite VNA, NAHC
  • Dave Totaro, BAYADA Home Health Care, NAHC
  • Nick Westfall, VITAS Healthcare, NHPCO

Melinda Gruber, proposed Vice Chair of the Transition Board, said, “Across the continuum of serious illness care, providers are looking to the future, working to ensure we can continue to provide high-quality, patient-centered care even as patient needs and payment models shift. The association representing providers should be similarly future-focused. This proposed Transition Board is the right group of people at the right time to take NHPCO and NAHC into the future, to continue providing value for our current and future members.”

Ken Albert, proposed Chair of the Transition Board, said, “With extraordinary opportunity comes the challenge of significant obligation. This proposed Transition Board is made up of experienced veterans of the care at home community, who possess the vision to understand both the opportunity and obligation to build an even stronger future for our sectors of the American health care delivery system. Fulfilling our pledge to return the home to the center of American health care will require a new organization with the expanded expertise of both NAHC and NHPCO. I am very confident that this talented group of leaders is up for the challenges ahead, and that our collective focus will remain on the needs of our members as they endeavor to meet the demands of providing high-quality healthcare.”

For more information, news, and updates on the collaboration, including recordings of the all-member Town Halls, please visit the collaboration update pages on the NAHC and NHPCO websites
 

Biden Administration Urges Judge To Throw Out NAHC’s Home Health Payment Lawsuit

Home Health Care News | By Andrew Donlan
 
In July, the National Association for Home Care & Hospice (NAHC) filed a lawsuit against the U.S. Centers for Medicare & Medicaid Services (CMS) and the U.S. Department of Health and Human Services over home health payment cuts. 
 
On Dec. 15, the Biden administration responded by asking a federal judge to throw out that lawsuit, in a move that NAHC considered a predictable outcome. 
 
“The government’s position in responding to the NAHC lawsuit, as set out in its December 15 brief, was fully expected,” NAHC President William A. Dombi said in a statement shared with Home Health Care News. “Virtually every lawsuit against Medicare includes an effort to dismiss the case on the grounds that the court does not have the power to adjudicate the complaints.”

The lawsuit, pertaining to CMS’ home health payment methodologies, was put forth when NAHC felt like it had “no other option left.” After continued advocacy in Washington, D.C., and attempts at legislation over the previous two years, NAHC felt legal means had to be pursued. 

In 2022, CMS finalized permanent cuts to home health payments. It did the same in 2023. 
 
HHCN has previously broken down some of the viable legal arguments against CMS’ continued cuts to home health payments. 
 
“We continued our conversations, discussions and advocacy with CMS in hopes of seeing something happening in the proposed rule that was issued last week,” Dombi said in July when the lawsuit was filed. “When that rule came out, CMS absolutely stuck to its position on the budget neutrality calculation methodology. It was decided that we really had no other option left to try to deal with that other than to go to court.”…

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CMS Releases FY2024 Mission & Priorities Document

NAHC Report

The Fiscal Year (FY) 2024 Mission and Priorities Document (MPD) developed by the Centers for Medicare & Medicaid Services’ (CMS) Quality, Safety & Oversight Group (QSOG) and Survey & Operations Group (SOG) was recently posted. The mission is to assure basic levels of quality and safety for all patients, residents and clients receiving care from Medicare and Medicaid certified institutional providers. 

The MPD is an annual document that directs the work of QSOG, SOG, and State Survey Agencies (SAs) based on regulatory changes, adjustments in budget allocations, new initiatives, and new requirements based on statute. The MPD covers survey, certification, enforcement, and the Medicare funding allocation process for states. Survey activities must be scheduled and conducted per the priority tier structure provided in the MPD. The four priority tiers reflect statutory mandates and program emphases, with tier 1 being the highest priority and tier 4 being the lower priority.

The MPD structure includes three sections: (1) new program updates since the issuance of the previous FY MPD; (2) standing information that is not anticipated to change throughout the year; and (3) listing of the priority tier structure for survey & certification activities by provider and supplier type.

A notable change from last year’s MPD is that CMS is moving up the priority for initial surveys for both home health and hospice.

  • Tier 1 – Providers/suppliers with a CMS-determined access to care issue.
  • Tier 2 – Provider/Supplier’s application to Medicare exceeds 150 days with a deeming option- If more than 150 days has passed since the MAC has recommended approval of the application and a deeming option exists, then the initial certification would be a Tier 2 priority.

In the past, initial certification surveys were classified as Tier 4. Also, in the MPD, challenges with State Agency (SA) surveyor staffing and a backlog of surveys is reiterated.  These challenges result in an emphasis being placed on complaints related to patient care with harm to patients taking the highest priority.

NAHC is aware that CMS is working on updates to the State Operations Manual (SOM), Chapter 10, that deals with the alternative sanctions for home health.  CMS intends to update this chapter and incorporate the enforcement remedies for hospice.  The sanctions/remedies include:

  • Civil money penalties;
  • Suspension of payment for all new admissions;
  • Temporary management
  • Directed plan of correction; and
  • Directed in-service training

The MPD mentions that CMS is working on these updates but a timeframe for when to expect these to be released is not shared.

NAHC is also aware that CMS has been working on updating the home health survey process which is found in Appendix B of the SOM.  Based on discussions with CMS, we believe this will include updates of the interpretive guidelines to incorporate clarifications of interpretations.  Unfortunately, a specific timeframe for this has not been shared and it is not mentioned in the MPD.
 

2024 Executive Forecast: What 6 Top Home Health Leaders Expect Next Year

Home Health Care News | By Patrick Filbin
 
Staffing shortages, rate cuts and Medicare Advantage penetration will continue to be trends in the home health market in 2024. Those aren’t new. What is new, however, is how providers plan to combat the issues that stem from those trends.
 
Home health leaders are focused on mitigating margin compression, utilizing more technology, leveraging artificial intelligence, working smarter with MA plans and more in the new year.
Home Health Care News heard from six of these home health industry leaders, who shared their views on the biggest trends, challenges and opportunities that will define home health care in 2024 and beyond.
 
***
 
We will continue to see the importance of traditional Medicare in the home health industry with increasing momentum on Medicare Advantage. Data and analytics to drive the value proposition will be an important focus for 2024. It will be essential that the industry has the data and outcomes to show the broader value impact — in addition to capacity, home health provides a more positive patient experience with lower costs.
 
We will continue to see labor challenges impacting market capacity. In addition, the impact to margin of the payer mix and specific payer strategies designed to maximize care will be critical in 2024. Exploring innovative ways to use technology and its effect on potential efficiency and care delivery will continue into 2024 as well.
 
I see home health as a huge driver of cost savings as well as offering better quality of life and outcomes for patients in 2024. The need to convey that to the payer community and the government is important. We should drive for efficiency as a challenge in 2024, but also to unlock opportunity. Care coordination with other important social determinant drivers – like personal care, transportation, meals delivery and physical activity, as well as clinical care coordination with the health system, primary care doctors and emergent referral sources for quality and timeliness of care, will all be important in the upcoming year.
 
There is great opportunity in market growth, as more and more people are in need of home care services. We will look to grow capacity in the market through workforce solutions, efficiency and unique partnerships of care delivery and coordination, all driving more market growth.
 
– Richard Ashworth, president and CEO of Amedisys
 
***
 
Several challenges from 2023 continue to impact home care — most notably, the recently finalized 2024 cuts to Medicare home care reimbursement rates. We will continue to advocate a rollback of these cuts, and with support for our position in Congress, we’re optimistic progress will come.
 
As the labor shortage continues, home care patient referrals continue to go unfilled. Recruiting and retaining talented clinicians is critical. We can expect more flexible hiring approaches including part-time positions, flex-time scheduling and gig labor across the industry.
 
2024 will bring growing emphasis on insurer efficiencies in coordinating home care services. For example, several national health plans are already taking steps to reduce authorization requirements and in a push to consolidate the managed long-term care (MLTC) market. In New York, the state is requiring low-performing MLTC plans to be absorbed into higher-performing plans — a process that’s now underway. Look, too, for insurers to accelerate the shift of dual-eligible Medicaid recipients to integrated Medicare-Medicaid plans — a trend we’re seeing in 
New York State and among national for-profit Medicare Advantage insurers.
 
Growth opportunities in 2024 include increased linkage of home care patients to community-based mental health providers — a promising option for addressing America’s mental health crisis. The use of technology — including AI — is evolving quickly in home health care to improve patient outcomes, reduce the administrative burden on clinical delivery and improve administrative efficiencies.
 
– Dan Savitt, president and CEO of VNS Health

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2024 Executive Forecast: What 9 Home Care Leaders Expect Next Year

Home Health Care News | By Joyce Famakinwa
 
While home care providers are working to mitigate headwinds – such as the rising cost of delivering care and staffing challenges – they also have their eye on where the industry goes from here. 
 
As 2024 approaches, home care leaders are embracing AI, alternative payer sources, employee-centric solutions and much more.
 
Home Health Care News heard from nine home care industry leaders, who shared their views on the biggest trends, challenges and opportunities that will define home care in 2024 and beyond. Some also noted where their organizations’ efforts will be focused next year. 
 
***
 
The home care market continues to expand due to growth in an aging population, increased prevalence of chronic conditions, and a continued consumer preference for the comfort and familiarity of home over institutions. While elder care is growing more quickly, I predict in the next 2-3 years, we will see an increase in home care utilization among a more diverse group of demographics — mainly helping support those with chronic conditions.
 
In 2024, I expect to see continued advancement in the integration of health care and home care fueled by technology and data collection. Remote monitoring for vitals and fall risks will help provide a more complete picture of patient health. Patient touch points will expand, furthering the collection of patient data. Increased capacity for predictive modeling through AI will empower home care leaders to enhance service offerings to improve the quality of care, patient health, comfort and independence.
 
Home care companies positioned to provide an integrated and individualized care plan leveraging new technologies will see the most significant consumer interest and build revenues through enhanced partnerships with referral sources.
 
— Emma Dickison, CEO and President at Home Helpers
 
***
Due to the increased cost of private-pay home care and economic uncertainty around a recession, we believe 2024 will be marked by shorter length of stay than we saw pre-pandemic. Like 2023, this will be driven by consumers delaying the start of care and/or ending services in favor of more cost-effective options such as family-provided care. This may be a challenging time for some operators, especially those without a mature sales funnel.
 
Outside of scaled operators, which are the minority in private-pay home care, M&A may continue to be slightly challenging for sellers. There may be less buyers for the average home care agency than in years past, meaning fewer LOI’s and softer offers. While Family Tree Private Care is still an active buyer, we expect that challenging debt markets in the first half of 2024 will compress most buyers’ ability to finance deals or support a purchase price that the average seller has come to expect…

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