HHS Rolls Out First National Family Caregiver Strategy
McKnight’s Home Care / By Diane Eastabrook
The Department of Health and Human Services unveiled its first national strategy to support family caregivers on Wednesday. Among the list of actions HHS recommended is the creation of a job classification for direct care workers and standardized training and accreditation across states.
“Supporting family caregivers is an urgent public health issue, exacerbated by the long-term effects of the COVID-19 pandemic,” HHS Secretary Xavier Becerra said in a statement. “This national strategy recognizes the critical role family caregivers play in a loved one’s life. I know the importance of this first-hand, as someone who cared for my late father and navigated the challenges associated with caregiving.”
The national strategy lists 350 actions the federal government will take to help family caregivers over the next year and 150 actions that can be adopted by state and local governments, as well as the private sector to build a safety net for family caregivers. They include:
- Increased funding to state, tribal and local health departments to embed family caregiving into public health infrastructure and planning
- Incentives for healthcare systems to incorporate family caregivers into healthcare decision-making
- Expansions to Medicare benefits, including respite care, adult day services and meals
- Financial support for caregiving initiatives through federal funding opportunities, including expansion of Older Americans Act and the Elder Justice Act funding opportunities
- Federal passage of family leave and expansion of FMLA to include smaller employers
The strategy is the result of the RAISE Family Caregivers Act, signed into law in 2018, which required HHS to come up with an action plan to aid family caregivers within 18 months of its passage. It was developed jointly through advisory councils and included input from family caregivers.
An estimated 53 million Americans provide informal, and typically unpaid, care to older adults and disabled people, according to the National Alliance for Caregiving and AARP. A 2015 study by AARP estimated family caregivers provide approximately $470 billion in unpaid care annually.
A poll released last week found one-third of family caregivers surveyed worried about juggling work and caregiving duties, while nearly half said using paid caregiving would reduce their emotional and physical stress. |
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Five Reasons Biden Might be Wrong About the Pandemic Being Over
The Hill / By Joseph Choi
President Biden boldly claimed in an interview over the weekend that the pandemic is over, but public health experts — and U.S. statistics — put those remarks in serious doubt.
Coronavirus cases and deaths in the U.S. have been on a steady decline in recent weeks following a slight rise due to the BA.5 omicron subvariant.
However, tens of thousands of new cases are still being recorded daily, hundreds of Americans are still dying of the virus every day and enthusiasm for immunization has all but stagnated.
In his “60 Minutes” interview, Biden acknowledged the U.S. still has “a problem with COVID,” but pointed to the fact that people were not wearing masks at the event he was attending as evidence that the pandemic phase of COVID-19 is over.
He sought to walk back the remarks on Tuesday, saying the pandemic is “not where it was.”
But he has maintained the core of his argument: COVID-19 has reached a new, less severe phase.
Many have been waiting for the pandemic to become endemic.
For a virus to be considered endemic, it would still exist within communities, but it would not severely impact medical providers and health systems.
Available information paints a picture of a country that, while making strides in combating the outbreak, is far from being in the clear.
Cases
While cases are declining, they are still far from being the lowest they have ever been throughout the pandemic.
Case rates for COVID-19 currently stand at a seven-day moving average of about 55,000 cases per day, a marked decline from the hundreds of thousands of infections that were seen at the start of this year when the omicron wave peaked.
This rate is still more than twice what the U.S. saw in April before BA.5 rose in dominance.
Since the start of the pandemic, case rates reached their lowest in June 2021 when they dipped below 12,000 per day for a few weeks.
Half of all U.S. counties are currently considered to have low COVID-19 community levels, according to the Centers for Disease Control and Prevention (CDC). Another 36 percent of counties have medium COVID-19 community levels, and 13 percent have high community levels.
This leaves half the communities in the country in a place where mask wearing is still recommended by the CDC in some situations, particularly for those at high risk for severe illness.
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Hoak to Home Care Agencies: Raise Your Game or Get Left Behind
McKnight’s Home Care / By Diane Eastabrook
Home Care Association of America CEO Vicki Hoak calls megadeals, such as CVS Health’s $8 billion acquisition of Signify Health, a potential plus for the home care industry. However, she warned home care agencies must step up their game if they want to have a role in the evolving healthcare industry.
“We as an industry have got to continue to be aggressive in our advocacy efforts to make sure we are part of that ecosystem,” Hoak told McKnight’s Home Care Daily Pulse Sunday at the HCOA Annual Leadership Conference in Orlando.
Large retailers, including CVS, Amazon and Walgreens Boots Alliance, are transforming the healthcare landscape through acquisitions that are moving more care into the home. Insurance companies are reshaping healthcare as well. UnitedHealth is expected to close on its acquisition of national home health and hospice firm LHC Group by the end of the year; Humana owns CenterWell Home Health. CVS owns Aetna.
Supplemental benefit offerings
Insurance companies have begun to see the value of home care by adding it as a supplemental benefit to Medicare Advantage plans. Currently, about 740 of the nation’s more than 4,000 MA plans offer home care services as a nonmedical supplemental benefit. However, many plans strictly limit the number of home care hours an enrollee can access annually.
In order to get more plans to offer the service and expand hours, Hoak said home care agencies have to prove their value to payers by their ability to keep beneficiaries healthy and out of the hospital. She said one way to accomplish that is through data that tracks patient care.
“When you look at the software that our members are using… it is very easy for them to put this information on their dashboard, and we’re working with them to do that,” Hoak explained. So in a way we already have the software; it’s just a matter of what does that software tell me? I think if you are going to stay in this business, you have to prove value and data is the way.”
Consumer in driver’s seat
While data may be the industry darling at the moment, the consumer is still king. HealthAlign CEO Andy Friedell, whose firm helps payers manage support services for beneficiaries, told HCAOA members that some MA plans are letting enrollees pick and choose the supplemental benefits they want.
“[MA plans] are saying to members, you can have ‘x’ amount of value and you can make decisions on how you want to spend that value across a range of services,” Friedell explained during a session Sunday on payers.
While the changing healthcare landscape could help savvy home care agencies expand their businesses, Hoak warns those who don’t adapt could get left in the dust. That could mean an industry, which currently has approximately 26,000 agencies, could look much smaller by the end of the decade. |
Home Health Value-Based Purchasing Model (HHVBP Communication)
On October 11th from 12:00 pm MT – 1:00 pm MT, the Home Health Value-Based Purchasing (HHVBP) Technical Assistance (TA) Team will present a live encore presentation of the August 25th webinar: Navigating Performance Feedback Reports: Interim Performance Report (IPR) and Annual Performance Report (APR). The encore presentation will contain the same content from the first webinar. This event will also include a live Q&A session.
During this event, the TA Team, using the sample reports now available on iQIES, will introduce the two (2) types of expanded HHVBP Model performance feedback reports: IPRs and APRs. Content will include a review of the purpose, availability, timing, and location of the reports, followed by a walkthrough of each report type and the content on each tab in the reports. The event will also include a segment showing how data populates from one table to another.
Understanding important details for each report type and navigating the reports are essential skills for an HHA to accurately and efficiently track, trend, and identify report information to interpret their Total Performance Score and potential payment adjustments, and inform Quality Assurance and Performance Improvement (QAPI) initiatives.
Register today at: https://us06web.zoom.us/webinar/register/WN_e5u1sYo1SdyFs1UqiN6nUw
** Prior to attending, HHAs should review and download the sample IPR and sample APR now available on iQIES. Instructions on how to access the sample reports are available on the Expanded HHVBP Model webpage, under "Model Reports." If possible, please join 5-10 minutes early.**
Shortly after the live event, an audio recording and the transcript will be available on the Expanded HHVBP Model webpage. The slide deck from the August 25th webinar is now available under "Model Reports." This slide deck will be the same used for the October 11th event.
For questions, email the Expanded HHVBP Model Help Desk at [email protected]. |
Lawmakers Zero in on Immigration to Address Caregiver Crisis
McKnights Home Care / By Diane Eastabrook
Momentum could be building in Washington to address the troubled immigration system as a way to solve the nation’s caregiver crisis.
Last week, both Republican and Democratic senators acknowledged that current immigration policy is making it difficult to recruit and retain foreign healthcare workers during a hearing in Washington. Sen. Alex Padilla (D-CA), chairman of the Senate Judiciary Subcommittee on Immigration, Citizenship, and Border Safety, said there continues to be a backlog in processing green cards for critical healthcare workers and caps on employment-based visa categories.
“Many of the federally recognized central workers that we relied on at the peak of the COVID-19 pandemic still risk uncertainty with their legal status in America,” Padilla said during the hearing. “In our hour of need, the United States is effectively discouraging potential healthcare workers from trying to come to and work in the United States. That needs to change.”
Last year, Padilla and Sen. Richard Durbin (D-IL) introduced the Citizenship for Essential Workers Act, which established a mechanism for immigrants who worked as essential workers during the COVID-19 pandemic to apply for and obtain permanent resident status. To be eligible, the workers must have earned income at any time during the pandemic that was deemed essential by the Department of Homeland Security or a state or local government. New York is one state that deemed home- and community-based caregivers as essential under a bonus program the state enacted over the summer.
Home care advocates, including the Home Care Association of America and LeadingAge, have been aggressively advocating for immigration reform as a way to address the shortage of caregivers. However, both groups favor the establishment of a new visa category for direct care workers that might allow agencies to either sponsor workers living outside the U.S. now or currently working here under another visa category.
An estimated 30% of the nation’s 2.3 million home care workers are immigrants, according to PHI National which tracks the direct care industry. |
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