Literature Review

What Hospice VBID’s ending means for palliative care Hospice News; by Markisan Naso; 5/1/24 The impending demise of the hospice component of U.S. Centers for Medicare & Medicaid Services’ value-based insurance design (VBID) model has largely been met with a sense of relief by providers as they plan new initiatives for palliative care in 2025. ... The program, which initially contained promising components designed to give patients better access to palliative care, instead became an increasing source of frustration for organizations. ... With the end date for the hospice component of the VBID model approaching, many palliative care providers are left with concern for their patients and questions about the coming transition, as they shift focus to what happens next.  Editor's Note: This article includes perspectives from Rory Farrand, Vice President of Palliative and Advanced Medicine at NHPCO, and Mollie Gurian, Vice President of Home-Based and HCBS Policy at LeadingAge.

Minnesota’s new labor board votes for nearly $23.50 an hour minimum wage for nursing home workers Minnesota Reformer; by Max Nesterak; 4/29/24 'Today has been a long time coming,’ said nursing home worker Nessa Higgins at a news conference after Minnesota’s first labor standards board voted on April 29, 2024, to raise the minimum wage for nursing home workers to $20.50 per hour by 2027. Minnesota’s new workforce standards board took its first significant vote on Monday, agreeing to raise the pay floor to $23.49 per hour on average in 2027 for nursing home workers, while guaranteeing 11 paid holidays. The worker and government representatives on the board approved the minimum wages without the support of the board’s nursing home industry representatives, who abstained.

Congresswoman Kat Cammack introduces legislation to block 80-20 Rule Home Health Care News; by Joyce Famakinwa; 4/26/24 ... On Thursday, Congresswoman Kat Cammack (R-Fla.) introduced a bill to block the U.S. Department of Health and Human Services (HHS) from finalizing the 80-20 provision. Additionally, the legislation would also block HHS from implementing any similar rules that place a minimum requirement for how much of Medicaid spending on HCBS goes towards direct workers’ wages. Cammack’s reason for introducing this legislation is her belief that the 80-20 provision will severely limit access to care at a time when providers are already struggling to serve patients.

How to overcome the disruptive forces that can impede high-value innovation Healthcare Financial Management Association (hfma.org); by Liz DeForest; 4/28/24 ... Healthcare is full of what we call “missing innovations” — good ideas that never go beyond promising pilot tests or, like EHRs, are adopted so slowly that their progress is measured in decades, even though other industries were adopting digital solutions very rapidly. Switchover disruptions are among the reasons for these missing innovations. ... [The author interviewed authors of Why not better and cheaper? (Oxford University Press, June 2023), written by industry analysts and twin brothers James B. and Robert S. Rebitzer about their observations of health system action and inaction. James Rebitzer is the Peter and Deborah Wexler Professor at Boston University’s Questrom School of Business. Robert Rebitzer is a national adviser at the consulting firm Manatt Health.]

Relief provisions not enough to mitigate damage of 80/20 policy, providers say McKnights Home Care; by Adam Healy; 4/24/24 Though newly finalized changes to the Medicaid Access Rule attempted to soften the blow of its controversial 80/20 provision, home care providers remained vehemently opposed to the Centers for Medicare & Medicaid Services’ strict new spending mandate. “Overall, while there are many positive provisions within the final rule as well as mitigations to make the payment adequacy provision less onerous, NAHC remains extremely concerned about the negative consequences of the pass-through policy,”  the National Association for Home Care & Hospice said in an analysis for NAHC members released after the rule was published. 

NAHC expresses disappointment regarding Medicaid Access Rule HomeCare; 4/23/24 The National Association for Home Care & Hospice (NAHC) released a statement noting that it was, 'extremely disappointed that the Centers for Medicare and Medicaid Services (CMS) elected to finalize the “payment adequacy” provision in the Medicaid Access Final Rule (CMS 2442-F).' "This is a misguided policy that will result in agency closures, force providers to exit the Medicaid program, and will ultimately make access issues worse around the country," a statement from the organization read. "As NAHC and our partners across the homecare industry have demonstrated, such a provision is not only unworkable due to the varied nature of Medicaid programs across the country, CMS also lacks statutory authority to impose this mandate."

Hospice groups, AOs speak out on proposed Accreditor Oversight Rule Hospice News; by Jim Parker; 4/22/24Some accreditation organizations (AOs) have balked at the U.S. Centers for Medicare and Medicaid Services’ (CMS) proposed rule designed to strengthen oversight of those institutions. ... Three such organizations currently have deeming authority for hospices, The Joint Commission, the Accreditation Commission for Health Care (ACHC) and Community Health Accreditation Partner (CHAP). These accreditors have joined a host of other stakeholders in making public comments on the proposed rule, with some requesting clarifications and others outright denying that CMS has the authority to establish such requirements.

How the FTC's ban on noncompetes will shake up healthcare workforce strategiesHealthleaders; by Jay Asser; 4/25/24CEOs will have to adjust their strategies to maintain their workforce if the final rule stands. Key Takeaways:

Medicare Advantage fight shifts to 340B arena Modern Healthcare, by Alex Kacik; 4/22/24Hospitals' fight to boost Medicare Advantage reimbursement has extended to plans' pay for 340B drugs. The hospitals’ plea to adjust Medicare Advantage pay stems from regulation aimed at making providers that participate in the drug discount program whole after the Supreme Court reversed 340B rate cuts that were in place from 2018 to 2022.

20M fewer Medicaid enrollees means trouble for providersModern Healthcare, by Nona Tepper; 4/23/24Over the past year, states have removed more than 20 million beneficiaries from Medicaid after suspending eligibility redeterminations during the COVID-19 public health emergency. Thousands of those people are Clinica Family Health patients. The Lafayette, Colorado-based community health center felt the pain of lost reimbursements when patients went from having Medicaid coverage to being uninsured, a fate that has befallen almost one-fourth of these former Medicaid enrollees nationwide, according to KFF. Clinica Family Health responded with cutbacks but is still in the hole. 

Save A Lot donates 7,000 pounds of food and $500 to local hospice Hazard Herald [KY], by Justin Begley; 4/18/24Save A Lot has once again lent its support by donating seven thousand pounds of food and water, along with a $500 gift card, to the Greg and Noreen Hospice Center. This year marks the fifth consecutive year that the grocery chain has made such a donation to hospice. Jason Smith, a district manager for Save A Lot, alongside management from other stores, was on hand to unload truckloads of supplies to replenish the hospice’s pantry ...

What home health providers can learn from CMS’ other proposed rules for 2025Home Health Care News, by Joyce Famakinwa; 4/19/24... CMS released the 2025 proposed payment rules for hospice and skilled nursing facilities (SNFs) in March. On the hospice side, the proposed rule included a 2.6% increase in the per diem base rate. Aside from the pay raise for hospices, the proposal also included a market basket index update, and notable changes to some of the geographic areas subject to particular indices. “There are rural areas that became urban and urban areas that became rural in the new CBSs — core based statistical areas,” William A. Dombi, president of the National Association for Home Care & Hospice (NAHC), told Home Health Care News.

Mississippi Capitol sees second day of hundreds rallying for ‘full Medicaid expansion now’Mississippi Today - Legislature; by Bobby Harrison and Geoff Pender; 4/17/24Hundreds of people rallied at the Mississippi Capitol for a second day Wednesday, urging lawmakers to expand Medicaid to provide health coverage for an estimated 200,000 Mississippians. ... Speakers recounted their struggles with access to affordable health care in Mississippi and chanted for the Legislature to, “Close the coverage gap now,” and for “Full Medicaid expansion now.” ... [Dr. Randy] Easterling recounted a story of two of his friends diagnosed with similar cancers. One was uninsured and self-employed, and did not get early diagnosis or treatment. He’s now in hospice and on death’s door. The other friend, with insurance, received an early diagnosis and treatment and is now cancer free.