HHS Offers States Flexibility to Better Address Medicaid Enrollees’ Needs

Home Care Association of America

Recently, the U.S. Department of Health and Human Services (HHS) and CMS released guidance to help states expand access to health care services and address health-related social needs for people with Medicaid coverage. The option of “in lieu of services and settings” in Medicaid managed care will help state offer alternative benefits to address unmet health-related social needs, such as housing instability and food insecurity.

​Provided via a state Medicaid director letter, the guidance establishes requirements that states must meet to ensure the services are cost effective, medically appropriate, preserve enrollee rights and protections, and fulfill the objectives of the Medicaid program.
 
For more information or to read the state Medicaid director letter in its entirety, visit Medicaid.gov. 

https://www.medicaid.gov/federal-policy-guidance/downloads/smd23001.pdf

Medicare Advantage, Telehealth Expansion Allies to Helm Key House Panels

Fierce Healthcare | By Robert King
 
The new leaders of the influential House Ways and Means Committee and the House Energy and Commerce Committee have previously been fierce advocates for extending telehealth services as well as preserving Medicare Advantage (MA).
 
Rep. Cathy McMorris Rodgers, R-Washington, was selected Tuesday as the head of Energy and Commerce. Rep. Jason Smith, Missouri, will helm the House Ways and Means Committee. Both panels have major jurisdiction over healthcare issues in Congress.
 
It remains unclear what the exact priorities for both lawmakers will be in the new congressional session. 
 
McMorris Rodgers has served as the ranking member of Energy and Commerce in the last Congress and has been critical of the Biden administration’s response to the COVID-19 pandemic. She has called for information and records from the National Institutes of Health on the origins of the COVID-19 pandemic, which will likely be the source of hearings across multiple committees in the coming years.
 
She is also likely to be a sharp critic of Centers for Medicare & Medicaid Services (CMS) policies on Medicaid and the Affordable Care Act.
 
McMorris Rodgers slammed CMS for approving a waiver by Washington state to enable undocumented immigrants to get subsidized coverage. Rodgers said in a statement last month that the waiver granted by CMS to Washington was a “misuse of taxpayer dollars.”
 
Both McMorris Rodgers and Smith are aligned on a key issue of how to keep around telehealth flexibilities. Smith told Axios that a big focus of his chairmanship will be on extending telehealth and improving access to healthcare in rural areas. 
 
McMorris Rodgers has also been a big proponent of the expansion of telehealth flexibilities created at the onset of the pandemic. 
 
Both lawmakers will likely play a pivotal role in the future of telehealth. At the start of the pandemic, CMS expanded the flexibility for providers to get Medicare reimbursement for telehealth. 
 
Congress passed legislation at the tail end of 2022 that extends those benefits through 2024. It may be up to Congress again to pass another extension or to decide which flexibilities should become permanent. 

Telehealth Continues

NIHCM

Telehealth emerged as a strong care delivery system during the pandemic. The US Department of Health and Human Services shared new insights on how telehealth programs could be strengthened. Congress expanded COVID-era telehealth flexibilities through 2024.

• Mental Health: A large study found telehealth to be as effective for treating anxiety and depression as in-person visits. Many schools are turning to telehealth to support students’ mental health needs. 
• Rural Health: Telehealth is connecting rural patients to sexual assault nurses, when before they had to travel to a hospital in another county for care. There is also emerging evidence of telerehabilitation in rural areas. 
• Substance Use: The Substance Abuse and Mental Health Services Administration proposes to expand access to opioid use disorder treatment by using telehealth to initiate buprenorphine at opioid treatment programs.

Resources & Initiatives:

• A recent study found that telehealth enabled mental health care for an increasing number of patients.
• Horizon Blue Cross Blue Shield of New Jersey shares information on when telehealth is the right choice for care.

Top Home Health Trends For 2023

Home Health Care News | By Andrew Donlan
 
Home health care’s 2022 was dimmed by the dark cloud of Medicare rate cuts. That cloud still hangs overhead in 2023.
 
To weather the storm, providers are scrambling to find answers to persistent problems, namely staffing shortages. At the same time, they’re renegotiating arrangements with Medicare Advantage (MA) plans and pivoting from certain service lines to others. They’re attempting to become more efficient – in any way possible.
 
Just like any new year in the home health industry, 2023 brings an onslaught of challenges, but also opportunities.
 
As January gets underway, the team at Home Health Care News took a stab at identifying top trends for 2023. The following are based on our research, reporting and extensive industry knowledge.
 
Curious what we forecasted for last year? Revisit our 2022 predictions here.
 
The number of home health agencies will continue to decline
 
Over the past few years, the number of existing home health agencies has steadily decreased.
 
In 2020, there were 9,378 agencies, compared to 9,893 in 2019 and 10,852 in 2014, according to the Research Institute for Home Care’s 2022 Home Care Chartbook.
 
There are a number of factors that suggest this will continue.
 
One of these is the ongoing staffing challenges providers are facing. While staffing has alway been a pain point, the impact of the pandemic has put a severe strain on recruitment and retention. Further compounding matters, nurses have left health care altogether due to burnout.
 
Even though the home health industry’s average turnover rate has gone down slightly, it hasn’t been a significant enough dent to improve staffing conditions for providers. There were signs of improvement in the back half of 2022, but perhaps not enough to keep up with mounting demand set forth by the country’s aging population.
 
In 2022, the turnover rate for LPNs was 30.25%, down from 36.54% 2021, and 31.19% for RNs, down from 32.35% in the previous year, according to data from the most recent Home Care Salary & Benefits report from Hospital & Healthcare Compensation Service.
 
Ultimately, not having enough labor has limited growth: Last year, David Totaro, chief government affairs officer at Bayada Home Health Care, said that the company had a nearly 67% referral decline rate. As an industry the home health decline rate was 58% last year, according to CarePort data.

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