In The News

The Latest on Monkeypox

By the National Institute for Health Care Management

The World Health Organization declared the monkeypox outbreak a global health emergency as the number of confirmed cases has increased to over 30,000 across 88 countries with more than 8,900 cases in the U.S. (as of August 8th, 2022). On August 4th, President Biden declared monkeypox a national public health emergency. 

  • Vaccines: The U.S. Food and Drug Administration announced that nearly 786,000 doses of the monkeypox vaccine will be made available for distribution. The Centers for Disease Control and Prevention (CDC) estimates that nearly 1.5 million people are eligible for the vaccine.
  • Not a Sexually Transmitted Infection (STI): While monkeypox cases have predominately been found among men who have sex with men, it is neither an STI nor does it only impact specific communitiesTransmission can occur through skin-to-skin contact, touching contaminated objects, respiratory secretions, and during pregnancy. Experts have warned that stigmatizing messaging reinforces stereotypes and can undermine response efforts, as was the case during the HIV/AIDS epidemic
  • Impact on Health Clinics: Sexual health clinics, which have already been under pressure from years of underfunding and COVID-19, are now on the frontline of the growing monkeypox outbreak. 
  • Outlook: Many have compared the response to monkeypox in the U.S. to that of the beginning of the COVID-19 pandemic. Despite recent expansions in testing capacity, areas are still facing shortagesdelays in getting results, and a lack of reliable ways to test.



Q&A on the Overdose Crisis

By the National Institute for Health Care Management

The CDC estimates that more than 107,000 Americans died of drug overdoses last year - a record high. Learn more about the overdose crisis:

Q: How are racial disparities widening in overdose deaths?
A: According to a CDC report, overdose deaths are increasing fast among Black and Indigenous people. Black people ages 15 to 24 had an 86% increase in death rates compared to a 34% increase among White people of the same age group. The disproportionate increase among Black and Indigenous people may be due to health inequities, like unequal access to treatment.

Q: What is the role of fentanyl in the overdose crisis?
Deaths involving illicitly manufactured fentanyl are on the rise, which is often mixed with other illicit drugs without the user’s knowledge. Fentanyl-related deaths in the U.S. occur more often than gun and auto-related deaths combined. The Drug Enforcement Agency warns of a nationwide spike in fentanyl-related mass-overdose events. 

Q: How does harm reduction reduce overdose deaths?
 The Biden administration’s strategy to address the overdose crisis is the first to incorporate harm reduction strategies, which include access to naloxone (the antidote to opioid overdoses), sterile needles, drug test strips, and supervised injection sites. 

Q: Are people with addiction able to receive treatment?
 A recent study found that 87% of people with opioid use disorder (OUD) do not receive evidence-based treatment. Medications for OUD can reduce opioid overdoses by 50%.

Q: What about people with chronic pain?
 The 2016 CDC guidelines for prescribing opioids for pain have been credited with leading to harmful consequences for patients with chronic pain. The 2022 proposed guidelines remove the upper limits for prescription opioids, emphasize a patient-centric approach, and expand on alternative treatments.

Resources & Initiatives:

SAMHSA’s National Helpline for individuals and families facing mental and/or substance use disorders is 1-800-662-HELP.


Another State Invests Millions Into Aging-In-Place Program CAPABLE

Home Health Care News
This month, the Colorado Visiting Nurse Association (Colorado VNA) received a $2.3 million grant from the state to expand its CAPABLE program and to provide care for more Medicaid members.

CAPABLE is an interdisciplinary program from the Johns Hopkins School of Nursing that combines nursing care, occupational therapy and handyman services. It stands for “Community Aging in Place — Advancing Better Living for Elders” and aims to prove that with modest investments and short-term interventions, aging adults can stay in their home longer while improving their quality of life.

“It’s very non-clinical in the sense that a clinician isn’t coming in with their knowledge and telling the older adult what to do,” Sarah Szanton, the dean of John Hopkins School of Nursing, told Home Health Care News. “It’s very much centered around what the older adult would like to be able to do in their home. Then the occupational therapist and the nurse will use their experience to help the person brainstorm strategies for doing it.”

CAPABLE started in Baltimore over 12 years ago and has expanded to over 25 cities in 23 states since then. In order to grow the program, the CAPABLE team typically joins forces with other organizations.

Colorado VNA has been providing CAPABLE services in the Denver area since 2017 and has served over 300 clients. This most recent expansion will be dedicated towards Colorado’s Medicaid beneficiaries, also known as the Health First Colorado program…

Read Full Article


Home Health Proposed Rule Comments Due August 16th

If you have not already done so, please comment on the 2023 Home Health Proposed Rule by Tuesday, August 16th. Comments can be made through the following link:

We have also included a draft comment letter template for you to use for your comments (in the event that you need it). CMS has to review and respond to every comment, so let’s let them know what we think and what the impact of the proposed rule would be should it remain in its current form.

It’s also important that we reach out to our Senators and Representatives and ask them to support the Preserving Access to Home Health Act (S.B. 4605), which would freeze the current payment rate in place, with the exception of annual market basket updates, through 2025. 

Calls and personal messages are best, but if you are short on time, a message has been pre-drafted and can be sent in seconds from the NAHC Virtual Advocacy Center.  

Contact us with any questions – and remember, comments to CMS are due Tuesday!


CMS Hospice Quality Reporting Programs Updates


On August 4, 2022 CMS announced the following updates that go into effect with this month’s HQRP data refresh.

  • Hospice Visits in the Last Days of Life (HVLDL): On July 26, 2022, the National Quality Forum (NQF) endorsed the claims-based measure, Hospice Visits in the Last Days of Life, or HVLDL as NQF #3645. According to CMS “HVLDL reflects the proportion of hospice patients who received in-person visits from a registered nurse or a medical social worker on at least two of the final three days of life. HVLDL is the re-specified measure replacing the HIS-based Hospice Visits When Death is Imminent (HVWDII).” The August 2022 refresh will be the inaugural month for public reporting for HVLDL, which replaces public reporting of HVWDII. Further information, including a link to the NQF website, can be found on the Hospice Quality Reporting Program (HQRP) Quality Measure Development webpage.

  • Public Display of Hospice Care Index (HCI): Public reporting will also be available for the HCI measure during the August 2022 HQRP data refresh. The HCI is a single Medicare claims-based measure that includes 10 indicators of hospice stay, including indicators like burdensome transition and visits near the end of life. The HCI Technical Report has been made available for download effective July 1, 2022.

  • Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Star Ratings: CMS is targeting the August 2022 refresh for inaugural public reporting of the new Family Caregiver Survey Rating Summary Star Rating for the CAHPS Hospice Survey measure scores. Beginning this month, it will be publicly reported for all hospices with 75 or more completed surveys over the reporting period. Star Ratings will be updated every other quarter (every six months). Prior to public reporting, CAHPS Hospice Survey results are adjusted for effects of mode of survey administration and case mix. Details with overview of the purpose, timeline and methods can be found on the website. The national and state Star Rating distribution reports for the most recent reporting periods are available for download.

Additionally, CMS shared two new videos with helpful explanations on HQRP and HCI:

For questions, email [email protected].

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