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The Latest on Viruses

National Institute for Health Care Management (NIHCM)

As COVID-19 hospitalizations are declining, many hospitals are updating the traditional hospital design model to better accommodate the next pandemic. Some familiar viruses, such as influenza, have returned in unexpected ways while other viruses, including monkeypox and enterovirus, have become more prevalent. 

  • Influenza: With COVID-19 precautions continuing to weaken and fewer individuals immunized against influenza, health officials are warning that this fall and winter may be an exceptionally severe flu season and that cases may begin to rise earlier than usual. The projected rise in flu and COVID-19 cases this winter could result in the long-feared "twindemic."
  • Monkeypox Cases: The US reported almost two-fifths of the world’s monkeypox cases. While new cases and serious complications are still occurring, transmission in the US appears to be slowing down. The CDC recommends that the monkeypox antiviral be reserved only for people at high risk for severe disease.
  • Perception of Monkeypox: Awareness of monkeypox surged over the summer in the US and public health experts continue to warn about stigmatizing monkeypox messaging as was the case during the HIV/AIDS epidemic. Increased awareness of monkeypox has also been accompanied by increased scrutiny for many individuals with skin conditions. For those that have contracted the lesion-causing virus, it continues to impact both physical and mental health.
  • EV-D68 in Children: In September, the CDC issued a health advisory about the nationwide increase in pediatric hospitalizations with severe respiratory illness who also tested positive for rhinovirus or enterovirus EV-D68. In rare cases, this virus can cause polio-like symptoms in children.
 

Hospice VBID Model to Expand in 2023

HomeCare via NAHC

WASHINGTON, D.C. (October 4, 2022)—On Sept. 29, 2022, the Centers for Medicare & Medicaid Services (CMS) released the list of Medicare Advantage (MA) plans that will participate in the Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model during Calendar Year (CY) 2023, including those that will participate in the MA VBID Hospice Benefit Component (an offshoot of the larger VBID model which began operation in January 2021).

For CY 2023, 15 plans are participating in the Hospice Benefit Component (two more than in 2022). These 15 organizations will test the inclusion of the Part A hospice benefit in MA benefits through 119 plan benefit packages (PBPs). The estimated number of hospice enrollees who will be part of the model starting in 2023 is not yet known; during CY 2022 CMS estimated that approximately 20,000 hospice enrollees would be part of the model.

While the VBID Hospice Benefit Component will be offered in 25 states and territories during CY2023 (up from 22 states and territories in CY 2022), no single plan will offer hospice state-wide. Two plans that participated in 2022 will no longer be participating in 2023—AvMed (which operated in Florida) and Intermountain Health Care (which operated in select counties of Idaho and Utah). The VBID Hospice Component will be offered by two plans in areas of six states and territories (California, New York, Ohio, Oregon, Pennsylvania and Puerto Rico).

If you are a hospice provider and the VBID Hospice Benefit Component is offered in your state and you are interested in determining whether it will be offered in your service area, CMS has posted a link on the VBID Page titled, “CY 2023 Hospice Benefit Component Model Participant Service Area and Contact Information”. This Excel spreadsheet contains information related to the states, zip codes and counties where the various PBPs will be operating.

 

Open Enrollment Starts 10/15. Are You Ready for Open Enrollment? Prepare by Previewing 2023 Health and Drug Plans Now.

Medicare Open Enrollment runs from October 15 to December 7, 2022. During this time, people eligible for Medicare can compare 2023 coverage options on Medicare.gov. Medicare.gov provides clear, easy-to-use information, as well as an updated Medicare Plan Finder, to allow people to compare options for health and drug coverage, which may change from year to year.

Medicare Plan Finder was updated with the 2023 Medicare health and prescription drug plan information on Saturday, October 1, 2022 to allow people to begin previewing health and drug plans before the enrollment period opens on October 15. 1-800-MEDICARE is also available 24 hours a day, seven days a week to provide help in English and Spanish as well as language support in over 200 languages. People who want to keep their current Medicare coverage do not need to re-enroll.

To view options for health and drug coverage, please visit the Medicare Plan Finder on Medicare.gov.

 

NHPCO Releases COVID-19 Hospice 1135 Waiver Easy Reference Guide

NHPCO has prepared a summary of COVID-19 Hospice 1135 Waivers, their provisions, and their expiration dates as an easy reference. The next 90-day extension of the COVID-19 Public Health Emergency must be announced by October 13, 2022. NHPCO will share further information following this announcement.

 

CMS Seeking to Create National Directory of Health Care Providers, Services

Home Health Care News | By Andrew Donlan
 
The Centers for Medicare & Medicaid Services (CMS) on Wednesday released a request for information regarding the creation of a “national directory of health care providers and services.”
 
The effort – a major undertaking – could eventually lead to a new database that better connects home health agencies to patients, payers and other stakeholders. 
Specifically, the agency is seeking public input on what a directory of this kind would do for providers and patients. In essence, CMS sees it as a centralized system of provider and patient information that would facilitate care coordination, health information exchange and data reporting efforts.
 
In theory, it sounds like exactly what health care experts – both in and outside of home-based care – have been pining for over recent years. Data, reporting and health care information at large remains fragmented, which has resulted in “interoperability” becoming a buzz word. 
CMS believes the directory would be of help in its efforts to improve access to care, reduce clinician burden and support that interoperability throughout health care. 
 
“Easy access to accurate and useful provider directory information is critical for patients trying to find health care that best meets their individualized needs and preferences,” CMS Administrator Chiquita Brooks-LaSure said in a statement. “CMS is seeking comment on how a National Directory of Health Care Providers and Services could better serve patients and reduce unnecessary burden placed on providers to maintain dozens of separate directories.”
The request-for-information period will be open until Dec. 6, 2022. 
 
“CMS is specifically requesting public feedback on the [directory] concept and potential benefits, provider types, entities and data elements that could be included to create value for the health care industry, the technical framework for a [directory], priorities for a possible phased implementation, and prerequisites and actions CMS should consider taking to address potential challenges and risks,” the CMS release read. 
 
CMS would obviously lead the directory. The agency also says the directory would utilize a “modern interoperable” technology that would allow payers to update their own directories from a single directory through an application programming interface (API).
 
Part of what the agency touted in its description of the directory is the enhancements it could make in the provider-payer relationship. 
 
As managed care gets more involved in both home health and home care – and agencies look to get into value-based care through risk-sharing with these plans – data sharing has become a major topic of conversation. 

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