Why the Home Health Industry Needs Improved Case Management Under PDGM, HHVBP
Home Health Care News | By Joyce Famakinwa
For home health providers looking to reduce confusion, increase patient and staff satisfaction and improve quality metrics, honing in on the case management model is the best way to do so.
This is especially true in the wake of the Patient-Driven Groupings Model (PDGM), and in the lead-up to the Home Health Value-Based Purchasing (HHVBP) Model’s expansion, J’non Griffin, a principal at SimiTree, noted during a presentation at the annual Illinois HomeCare & Hospice Council (IHHC) conference on Wednesday.
“Remember that under HHVBP one of our main goals is patient outcomes,” she said. “Case managers need to be looking at, overall, how is this patient progressing in their goals?”
A shifting of mentality in regards to case management is in order, she argued. This means that providers should adopt the mindset that case management begins at the referral.
“How many [providers] have case managers that are in contact with their intake department and understand – just from the referral – what is needed for that patient?” Griffin said. “Probably not a lot.”
Starting case management at the referral stage contributes to a good hand-off between referral intake, the clinical manager and admitting clinicians, according to Griffin.
“The case manager’s responsibility is to act as the air traffic control,” she said.
Part of this case management mentality shift is also recognizing and leaning into the several factors that result in quality episode management. This includes a proper assessment of the patient, critical thinking, a comprehensive plan of care, coordination of care, patient engagement and multidisciplinary team care.
Additionally, the case manager should also reinforce agency policies and expectations, stay on top of producing timely and accurate documents and bolster patient experience. Griffin noted that patient experience plays a big role in HCAHPS scores.
“How often is somebody talking to you about your medications?” she said. “If you call into the office, how responsive are they? All of that is in your HCAHPS questions.”
It’s also important to recognize that not everyone makes a good case manager…
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In Post-Acute Care, Many Prefer to Go Home
Managed Healthcare Executive | By Ron Southwick
More patients are opting for home health services over skilled nursing facilities, and a new analysis expects that trend to continue.
In an analysis of post-acute care trends, Trella Health noted an uptick in home health instructions between 2020 and 2021, while skilled nursing instructions dipped over the same time frame. In fact, the skilled nursing industry’s struggles look to continue for the foreseeable future with no end in sight, the report states.
In its 2021 Post-Acute Trend Industry Report, Trella Health also pointed to the growth of Medicare Advantage enrollment, opportunities for telehealth and projections for expansion of the hospice industry. Trella Health, based in Atlanta, Ga., provides data analytics for post-acute care providers, including home health agencies, skilled nursing facilities and hospice providers.
After a dip due to the emergence of COVID-19, post-acute care instructions rebounded to pre-pandemic levels. Between the fourth quarter of 2020 and the third quarter of 2021, post-acute care instructions rose to 52.2%, up from 51.1% during the previous four quarters.
Here is a rundown of some key findings in the Trella Health report…
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Despite Strong Bipartisan Support, Choose Home Facing Roadblocks
Home Health Care News | By Patrick Filbin
Although Congressional support continues to grow for the Choose Home Care Act of 2021 in Washington, D.C., the legislation remains in limbo.
Other pieces of legislation for lawmakers have pushed the Choose Home bill down the priority list, but National Association for Home Care & Hospice (NAHC) President William A. Dombi is hopeful something will come of it soon.
“Priorities in Washington became politics,” Dombi told Home Health Care News last week at the Capital+Strategy conference. “The amount of air in Washington to deal with new things kept disappearing.”
Choose Home — among other things — supports in-home care alternatives to skilled nursing facilities (SNFs). If enacted, the legislation would enable certain Medicare patients to receive extended care services as an add-on to the existing Medicare home health benefit for 30 days following a hospital stay.
In addition to receiving skilled nursing or rehabilitation services from their home health provider, for example, a patient could potentially receive meals, non-emergency transportation, remote patient monitoring and more.
The idea is to give today’s highly diversified in-home care providers more flexibility and financial support to keep at-risk Medicare beneficiaries at home and out of costlier facility-based settings, in turn saving the U.S. health care system hundreds of millions of dollars a year.
Endorsed by the AARP and supported by a long list of home-based care advocates, Choose Home started gaining momentum on Capitol Hill early in 2021.
Now that Congress is through the budget and the U.S. government is trying to figure out how to properly aid and assist Ukraine, there should be time for Choose Home in political schedules, Dombi said.
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HHS Renews Public Health Emergency, Keeping Key Home Health Waivers in Place
Home Health Care News / By Robert Holly
The U.S. Department of Health and Human Services (HHS) on Wednesday opted to renew the COVID-19 public health emergency (PHE), keeping in place several regulatory waivers that have been critical lifelines for home health and hospice operators since the start of 2020.
While the extension itself is not surprising, it offers further stability as operators struggle with workforce shortages and general inflation, among other challenges. On top of that, the move gives hospital-at-home stakeholders extra time under the Acute Hospital Care at Home waiver, as they work on gaining support for corresponding legislation in both the House and Senate.
The PHE has been repeatedly renewed since implemented by the Trump administration over 24 months ago.
Without action from HHS and the Biden administration, it was set to expire on April 16.
“With more than two years having passed since the COVID-19 pandemic began in early 2020, questions are being raised about when to end the public health emergency declarations made by the federal government early on, with some advocating for their extension and others calling for their expiration,” Kaiser Family Foundation experts wrote in a recently released issues brief. “There are numerous implications to ending these emergency declarations.”
Wednesday’s extension is for another 90 days, which will carry the PHE into July.
Under the PHE, federal regulators have waived or modified normal requirements for Medicare and Medicaid providers, plus private health insurers. While some waivers have focused on reducing reporting and supervision requirements, others have revolved around new telehealth allowances and funding support.
Medicare-certified home health agencies, in particular, have had access to a long list of waiver flexibilities…
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