Literature Review

Home care industry slams finalized 80-20 Rule, warns agency closures are coming Home Health Care News, by Andrew Donlan; 4/22/24 The “Ensuring Access to Medicaid Services” rule has been finalized. Most importantly, the bemoaned “80-20” provision has gone through as proposed, meaning providers will eventually be forced to direct 80% of reimbursement for home- and community-based services (HCBS) to caregiver wages. ... Organizations like the National Association for Home Care & Hospice (NAHC) and LeadingAge immediately condemned the rule being finalized on Monday. ...

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.

'Speak Up & Speak Out,' LeadingAge members head to the Hill on Lobby Day 2024 HomeCare; 4/18/24 Senator Mike Braun (R-IN) joined Katie Smith Sloan, president and CEO of LeadingAge, and hundreds of the association’s nonprofit and mission-driven members for the kick-off of annual Lobby Day activities. More than 225 LeadingAge members, who serve older adults and families nationwide in a range of care settings and community types, ... headed to Capitol Hill on Wednesday, April 17 ...  [Leading Age members] visited their elected officials in the House and Senate to discuss critical aging services issues to ensure older adults and families can access the care and services they need to age with dignity, including [but not limited to]: 

Home care sees largest price jump in history, BLS report finds McKnights Home Care, by Adam Healy; 4/15/24The cost of home care rose faster than ever in the last year, far outpacing inflation across every other healthcare spending category, according to the Bureau of Labor Statistics’ latest Consumer Price Index report. Home care costs rose 14.2% between March 2023 and March 2024 — its most rapid growth since BLS began tracking data for the segment in 2005, according to the CPI. ... During the same period, standard inflation for all medical care services was 2.1%. The costs of hospital services — outpatient hospital services (8.3%), general hospital services (7.5%) and inpatient hospital services (6.9%) — saw the next-highest inflation rates since March 2023, eclipsed only by home care services. Meanwhile, prices for nursing home and adult day service rose by about 3.9%.Editor's Note: This article did not report cost changes for hospice care.  

Message-based telehealth an increasingly important part of seniors’ healthcare, study findsMcKnights Senior Living, by Aaron Dorman; 4/11/24 Many healthcare experts, and even government agencies, are working to try to expand telehealth coverage for older adults. But much of that work considers telehealth in terms of video and/or phone conversations. E-mails and digital messaging across patient portals, however, also are part of seniors’ healthcare regimen, particularly those who are Medicare beneficiaries, finds a new study published in Health Affairs Scholar. As such, updated telehealth coverage decisions should factor in the time that older adults, their caregivers and clinicians need to exchange these messages, the researchers said.

‘Are nursing homes our only option?’ These centers offer older adults an alternative. Rhode Island Current, by Anna Claire Vollers; 4/12/24PACE centers attract bipartisan interest and, in some states, scrutiny. ... PACE (Program of All-Inclusive Care for the Elderly) centers provide government-funded medical care and social services to people older than 55 whose complex medical needs qualify them for nursing home care, but who can live at home with the right sort of help. ... Nationally, PACE centers are owned by a variety of health care organizations, including nonprofits, for-profit companies, large health care systems and religious organizations. ... [The] explosive growth has come with challenges ...

Home Healthcare Market worth $383.0 billion by 2028 Iowanews Headlines; 4/11/24 [The] Home Healthcare Market in terms of revenue was estimated to be worth $250.0 billion in 2023 and is poised to reach $383.0 billion by 2028, growing at a CAGR of 8.9% from 2023 to 2028 according to a new report by MarketsandMarkets™. The primary drivers propelling the growth of this market are the aging population, rising healthcare expenditures, and the increased need for home care due to technological advancements in home healthcare.

AMA, AHIP, NAACOS outline value-based care best practices Modern Healthcare, by Nona Tepper; 4/10/24 Health insurers, physicians and accountable care organizations issued recommendations Wednesday outlining what they see as the best ways to boost value-based care initiatives. The report from the health insurance trade group AHIP, the American Medical Association and the National Association of ACOs focuses on total-cost-of-care contracts, ACOs that typically span three to five years and have demonstrated success improving quality and reducing costs, according to the organizations.

How MA Plan design affects utilization, health equity MedCity News, by Marissa Pescia; 4/8/24 A new study found that enrollees with zero-premium MA plans are three times as likely to be non-White compared to other MA enrollees and traditional Medicare enrollees. ... The study was published by Harvard Medical School and Inovalon, a provider of cloud-based software solutions. It used Inovalon’s Medical Outcomes Research for Effectiveness and Economics Registry dataset, which “tracks demographic characteristics and outcomes for about 30% of all MA members at any given point in time,” according to the report.

Dane County Board approves funding for hospice care program for homeless individualsABC TV 27 WKOW, Madison, WI; by Chloe Morrissey; 4/6/24Multiple organizations aiming to combat homelessness received approval for funding after Thursday night's Dane County Board meeting. One organization, Solace Friends, will be receiving $100,000 for the creation of Solace Home. It's a hospice program for housing insecure individuals given less than 6 months to live. The home can serve up to four people at one time who are currently living on the street, in a shelter or an unstable housing situation. 

CMS: Contract Year 2025 Medicare Advantage and Part D Final Rule (CMS-4205-F)CMS, Medicare Part D, Policy; 4/4/24On April 4, 2024, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that revises the Medicare Advantage Program, Medicare Prescription Drug Benefit Program (Medicare Part D), Medicare Cost Plan Program, Programs of All-Inclusive Care for the Elderly (PACE), and Health Information Technology Standards and Implementation Specifications. Additionally, this final rule addresses several key provisions that remain from the CY 2024 Medicare Advantage and Part D proposed rule, CMS-4201-P, published on December 14, 2022. ... This fact sheet discusses the major provisions of the 2025 final rule which can be downloaded here: https://www.federalregister.gov/public-inspection/2024-07105/medicare-program-medicare-advantage-and-the-medicare-prescription-drug-benefit-program-for-contract

Medicare Program; FY 2025 Hospice Wage Index and Payment Rate Update, Hospice Conditions of Participation Updates, and Hospice Quality Reporting Program Requirements Federal Register; A Proposed Rule by the Centers for Medicare & Medicaid Services on 4/4/24This document has a comment period that ends in 53 days, 5/28/24.This proposed rule would update the hospice wage index, payment rates, and aggregate cap amount for Fiscal Year (FY) 2025. This rule proposes changes to the Hospice Quality Reporting Program. This rule also proposes to adopt the most recent Office of Management and Budget statistical area delineations, which would change the hospice wage index. This rule proposes to clarify current policy related to the “election statement” and the “notice of election”, as well as to add clarifying language regarding hospice certification. Finally, this rulemaking solicits comments regarding potential implementation of a separate payment mechanism to account for high intensity palliative care services.