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Latest News from the Alliance for Home Health Quality and Innovation
July 2016

Dear Members and Friends:

It might be an understatement to say the last few weeks have been busy at the Alliance.
 
Two weeks after releasing a new data analysis centered on the episodes of care used in the Centers for Medicare & Medicaid Services (CMS) Comprehensive Care for Joint Replacement (CJR) model last month, the Alliance hosted the briefing “Framing the Future of Home Health Care in America” on June 30th in Washington, DC to preview the Future of Home Health Project findings. Representatives from Avalere Health, as well as Alliance Chairman Kathleen Gilmartin, President and CEO of Interim Healthcare, and Alliance Vice-Chairman Dr. Steven Landers, President and CEO of VNA Health Group spoke about the Project and its high level take-aways. Materials and a replay of the event available at: http://ahhqi.org/home-health/future-project-framework-release.
 
In early July, the Centers for Medicare and Medicaid Services (CMS) released the Calendar Year (CY) 2017 HH PPS proposed rule. The proposed rule highlights an estimated $180 million in cuts to home health agencies in 2017 and can be found here. The Alliance is working with members of our working groups, as well as other key industry leaders, on drafting comments. Comments are due by 5 pm ET on Friday, August 26th.
 
Additionally, the Alliance and the Visiting Nurse Associations of America (VNAA) hosted two webinars on new initiatives for the home health community regarding funding for interoperability and the Settlement Conference Facilitation Pilot. Slides and replays of each webinar are available at: http://ahhqi.org/education/webinars.
 
Finally, be sure to stay tuned to Alliance emails over the next few weeks, as we will be announcing a new event with VNAA on October 17-18, 2016 in Chicago!
 
If you’re interested in the Alliance’s recent programming or upcoming projects and events, I encourage you to reach out to me at tlee@ahhqi.org or (571) 527-1530 at any time.


Very Truly Yours,

Teresa L. Lee, J.D., M.P.H.
Executive Director

 
  • On July 5th, CMS posted the “Medicare and Medicaid Programs; CY 2017 Home Health Prospective Payment System Rate Update; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements” proposed rule in the Federal Register. This year’s proposed rule implements the final year of the four-year rebasing cuts, bringing the national, standardized 60-day payment rate rebasing adjustment to -$80.95, and the second of the three-year phase-in of case-mix adjustments, implementing a 0.97 percent reduction to the standardized 60-day rate. Other highlights from the proposed rule include changes to the home health value-based purchasing model, four new measures for CY 2018 to meet IMPACT Act requirements, and new payment and billing approaches for disposable Negative Pressure Wound Therapy. The full proposed rule is available here, and comments are due by 5 pm ET on Friday, August 26th.
  • On June 30th, the Alliance hosted “Framing the Future of Health Care in America,” which included the release of case studies and appendices that will inform the upcoming independent publication of the Future of Home Health paper. Kathleen Gilmartin, CEO of Interim HealthCare, Sally Rodriguez, Director, Avalere, and Dr. Steven Landers, President and CEO of VNA Health Group. Materials are available here, while a replay can be watched here.
  • CMS recently released a fact sheet on “Transforming Post-Acute Care Through Standardization and Care Coordination” available here. The CMS fact sheet focuses on CMS’s efforts toward data standardization in assessment instruments, which are required by the IMPACT Act.
  • In early June, the Centers for Medicare & Medicaid Services (CMS) announced the “Pre-Claim Review Demonstration for Home Health” in five states: Illinois, Florida, Texas, Michigan, and Massachusetts beginning August 1, 2016 in Illinois and continuing implementation through 2016 and early 2017. The demonstration is more or less the previously proposed Prior Authorization demonstration, requiring home health agencies to submit supporting documentation while beneficiaries are receiving care. You can find the official notice here, along with FAQs and a fact sheet.
  • Last month, the Alliance released a new data analysis on CMS’s Comprehensive Care for Joint Replacement (CJR) model, which found that the use of home health after a hospital stay is associated with cost effective care and lower readmission rates for Medicare patients who have undergone major joint replacement surgery. The analysis by Dobson | DaVanzo and Associates closely examines the distribution of discharges for patients from the hospital to various post-acute care (PAC) settings, the average Medicare payment per episode by first PAC setting, and the average readmission rate for related conditions. The full analysis can be found here in either Excel or PDF here.
  • On July 7th, the Alliance and VNAA hosted a webinar with Tom Novak of the Office of the National Coordinator for Health Information Technology (ONC) on their new interoperability initiative that could potentially offer HIT funding for Medicaid home health agencies. The Centers for Medicare & Medicaid Services’ (CMS) new initiative is aimed at better connecting the Medicaid program by broadening the scope of providers available for the 90% enhanced matching funds. The initiative is meant to facilitate better and more timely data sharing between a patient’s numerous providers. More information is available through the CMS Blog here, CMS’s letter to state Medicaid directors here, and this article from Healthcare DIVE. Webinar materials and replay are available here.
  • On July 14th, the Alliance and VNAA hosted a webinar with the Office of Medicare Hearings and Appeals’ (OMHA) Senior Attorney, Cherise Neville and her colleagues, on the Settlement Conference Facilitation pilot. The pilot allows for appellants and the Centers for Medicare & Medicaid Services (CMS) to discuss a mutually agreeable resolution for claims appealed to the Administrative Law Judge (ALJ) hearing level of the Medicare claim appeals process. The SCF pilot is available for both Part A and Part B claims, subject to eligibility requirements. Webinar materials and replay are available here.
 
  • Don’t miss a new financial leadership event hosted by the Alliance and VNAA October 17-18, 2016 in Chicago! More information and registration will be available shortly.
  • Registration is now available for the VNAA Public Policy Leadership Conference September 14 – 15, 2016 in Washington, DC featuring a keynote from Dr. Patrick Conway, Deputy Chief Administrator for Innovation and Quality and Chief Medical Officer at CMS. Topics will include implementation of home health value-based purchasing, unified payment models, and more. Register here! Early bird closes July 1st.
  • Next month, VNAA is offering a free webinar on Program for Evaluating Payment Patterns Electronic Report (PEPPER) on Wednesday, August 17th at 1 pm ET. CMS contractor Kimberly Hrehor, MHA, RHIA, CHC, director of the TMF Health Quality Institute, will be on hand to discuss how to access HHA comparative data reports and how they can give you a heads-up if you may be at risk for an audit. 
  • Check out the Alliance’s new state one-pagers on home health’s role in post-acute care! You can also check out the updated patient and workforce state one-pagers and packets with information from the 2015 Home Health Chartbook and supplements. Updated one pagers are available on our website: http://ahhqi.org/home-health/state-data
  • The Alliance (@AHHQI) will host the July edition of the #HomeHealthChat on Twitter on July 26th at 2 pm ET with co-host the Partnership for Quality Home Healthcare (@PQHH). The July chat will focus on patient access to home health care in the future. If you are interested in co-hosting an upcoming Twitter chat with the Alliance, please contact Jen Schiller at jschiller@ahhqi.org.
On June 30th, the Alliance hosted “Framing the Future of Health Care in America,” which included the release of case studies and appendices that will inform the upcoming independent publication of the Future of Home Health paper.
 
Leading experts and stakeholders provided an overview of the report and shared an initial vision to support the transformation of home health and home-based care as an integral part of the overall health care delivery system. Our panel included Kathleen Gilmartin, CEO of Interim HealthCare, Sally Rodriguez, Director, Avalere, and Dr. Steven Landers, President and CEO of VNA Health Group.
 
Read more here.
Smarter Ways to Teach Family Members Medical Skills
The Wall Street Journal, 7/18/16
“As hospitals send patients home after shorter stays and many patients live with multiple chronic diseases, more families are taking on complicated medical tasks. That includes giving injections, changing surgical dressings and operating special medical equipment, often with little instruction.”
To read more, click here.
 
More Older Americans Cared for at Home
U.S. News & World Report, 7/12/16
“More older Americans with chronic health problems are opting to live at home, relying on help from family, paid caregivers or friends, a new study finds.”
To read more, click here.
 
Independence at Home Demonstration Could Become Permanent
Home Health Care News, 7/11/16
“A pilot program that incentivizes home-base health care delivery might become a permanent, national Medicare program if lawmakers’ recent legislation is approved.”
To read more, click here.
 
Nurse on the go: a day in the life of a home health care nurse
The Daily Progress, 7/10/16
“The job of a nurse does not just end when the patient leaves the hospital or the nursing home. Augusta Health has a special unit of nurses that continue to go and visit patients, checking on them, their medicines and vitals even after they have left the hospital facilities.”
To read more, click here.
For the latest home health research, fact sheets, and value materials, visit www.ahhqi.org.
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