NBC Reports on Hospitals Pushing Hospice Care to Influence Mortality Rates

The Health Group

Recently, NBC News reported on hospitals transferring patients to hospice programs to reduce hospital lengths-of-stay and improve hospital mortality rates.  Transfers to hospice care reduce a hospital’s mortality rate.  If a person dies after transferring to hospice care, even if the patient remains in the same hospital and in the same bed, the death does not count toward the hospital’s inpatient mortality rate as the patient was transferred from the hospital into the care of the hospice.  The report is available here. 

In June 2023, the U.S. Department of Health and Human Services, Office of Inspector General (“OIG”) has added the “Audit of Selected, High-Risk Medicare Hospice General Inpatient Services” to the OIG Work Plan.  According to the Work Plan addition, “GIP care is provided only for pain control or acute or chronic symptom management that cannot be managed in other settings. It is intended to be short-term care. For this audit, we will focus on claims for enrollees who were transferred to GIP care immediately after an inpatient hospital stay for a period during which the enrollee's inpatient stay reached or exceeded the geometric mean length of stay for the assigned diagnosis-related group. These hospice GIP claims are at high risk for inappropriate billing because GIP care may exceed an enrollee's needs or may not be provided. We will determine whether hospice providers that billed for GIP care complied with Medicare requirements.”  Work Plan items are available at Work Plan | Office of Inspector General | U.S. Department of Health and Human Services.

The Future for Senior Care Within Medicare 

McKnight’s Home Care
 
This much is known: The current state of Medicare does not adequately support the needs of many of the aging baby boomers. For those who require a more hands-on approach to care, their coverage is considerably lacking.
 
Adults who are in need of assistance with basic daily activities such bathing and grocery shopping are left to their own devices, which often equates to the need for a family member to step in as a caregiver. While this can be an advantageous option, it can also lead to burnout in the long term. Thankfully, we, as home healthcare providers, are closing the gap as we offer options that allow for as much as 24-hour care.
 
How is care covered currently?
 
Currently, senior care is financed through various means, including private pay, auto insurance (PIP), aide and attendance (through the VA), long-term care insurance and limited coverage provided by Medicare for home healthcare. In most cases, nurses are accessible for a quick check-in and are on their way. This leaves little to no opportunity for help with the various needs of the patients, hence the Medicare care gap we are witnessing.
 
As of 2023, Medicare primarily covers home health care services that are considered skilled services. This includes medical services provided by healthcare professionals such as nurses and therapists. Medicare provides coverage for up to nine weeks at a time, subject to specific eligibility criteria. However, as we noted above, Medicare does not cover non-skilled personal care services, which are essential for seniors who require assistance with activities of daily living and instrumental activities of daily living.
 
“To improve is to change; to be perfect is to change often.”
Winston Churchill
 
Expanding Medicare coverage for non-skilled care
 
Unsurprisingly, there is a growing demand for coverage of non-skilled home care services to promote seniors’ independence and well-being. As the need for these services continues to rise, there is a possibility of expanding Medicare coverage to include non-skilled home care. A development such as this would significantly enhance the affordability and accessibility of senior care services for Medicare beneficiaries. Currently, funding these services is difficult for many families, and as a result, many families lack the care they need for their loved ones. Unfortunately, there is no concrete evidence that this change will take place at any point in the future, though it’s likely that countless families are calling for this.
 
The future of senior care within the Medicare realm is more than likely to witness a greater integration of technology and telehealth solutions. Following the pandemic, both seniors and caregivers were able to witness the power of telehealth. Seniors who struggle to move about easily were able to remain in the comfort of their own homes for many medical appointments.
 
This has continued to transform the healthcare industry as a whole, with no sign of looking back. In fact, according to a recent survey conducted among physicians primarily serving Medicare fee-for-service and Medicare Advantage patients, it is projected that by 2025, an estimated $265 billion worth of care services for beneficiaries could be transitioned from traditional facilities to home-based settings...
 
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Hospice and Home Health Accreditation Intensives

July 25-28^th  

These back-to-back Hospice and Home Health Accreditation Intensives are an interactive and engaging learning opportunity for our CHAP Hospice and Home Health Accreditation customers. Regardless of what stage of the accreditation process you are in or what role you have in the organization, this training can help you stay in compliance! 

These events will focus on: 

• The accreditation process
• The CHAP accreditation Standards
• The most cited deficiencies  
• Strategies to implement improved compliance within your own organization

Register for Hospice

Register for Home Health

Home Health Providers See Age-Friendly Accreditation As Competitive ‘Differentiator’

Home Health Care News / By Andrew Donlan
 
Last year, the Community Health Accreditation Partner (CHAP) received part of a $2.3 million grant from The John A. Hartford Foundation (JAHF) to bring the Age-Friendly Health Systems movement to home-based care.
 
Almost a year later, home health providers have implemented the framework – including Enhabit Inc. (NYSE: EHAB) and Compassus – and are seeing it as a potential differentiator moving forward.
 
“It’s competition in a way that makes everybody better,” Bud Langham, the EVP of clinical excellence and strategy at Enhabit, told Home Health Care News. “You can see that in the Age-Friendly Health Systems, there’s thousands of organizations who’ve already gone through a similar process on the inpatient side. You don’t want to be that one system in a marketplace that hasn’t been certified age-friendly. My hope is every single market where we achieve this certification, it raises the bar so that everybody has to step up.”
 
Based in Dallas, Enhabit provides home health and hospice services across 252 home health locations and 105 hospice locations in 34 states.
 
The age-friendly framework is supposed to elevate care for patients, but in a way that also benefits their families, referral sources and payers. It concentrates on “what matters”, medication, mentation and mobility – the “four Ms.”
 
As more care is moved to the home, age-friendly advocates – namely CHAP – believe this is a way to elevate the industry as it gains a brighter spotlight. Beginning in April, home health providers across the country have had the option to achieve a certification for Age-Friendly Care at Home.
 
“The only way we can really move the needle on outcomes is through patient involvement,” CHAP COO Teresa Harbour told HHCN. “And this is exactly what care this does, it gets that patient involved in their care. This is a perfect opportunity for organizations to provide that staff education on how to engage patients in their care and how to talk to them and determine what matters to them.”
 
A value-based care driver
 
Providing care in line with a patient’s goals was always sensical. But, the four Ms around Age-Friendly Care at Home fit in perfectly with the Home Health Value-Based Purchasing (HHVBP) Model as well.
 
Part of the calculation behind HHVBP is patient satisfaction scores. If patients are receiving care that they believe is specifically tailored toward them, providers are much more likely to receive high scores from those patients…

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