Joe Biden announced as part of his presidential campaign a policy proposal to invest $775 billion to expand access to home-based health care delivery for our nation’s aging population. The home health benefit provided by Medicare (and many other payers) encompasses a wide range of services that can be delivered in a patient’s home. These types of services can be a life-line for vulnerable patients, including the Medicare population that is at increased risk of developing serious complications from Covid-19.
A. 81% of physicians now refer their patients to home health agencies. “We’ve definitely seen an increase in referrals directly from physicians,” said Bud Langham at Encompass Health has seen more physician groups. ‘Home health agencies have probably not gotten the credit they deserve,’ said Todd Montigney, founding partner of BlackTree Healthcare Consulting. “With Covid-19, we’re seeing patients who don’t want to go to hospitals or skilled nursing facilities”.
Value-based care arrangements link quality, outcomes, safety and other measures directly to reimbursements. The use of home health services following inpatient care “decreased the hazard of follow-up hospital readmission and death,” according to Cleveland Clinic researchers. Biden cited The Johns Hopkins School of Nursing’s CAPABLE Program as an innovative way to reduce costs associated with hospitalizations.
Home health organizations are embracing technology to improve care coordination. Encompass Health is constantly assessing and growing its capabilities in the telemedicine space. AccentCare sees an incredible opportunity for technology and virtual care to improve patient care, while reducing Covid-19 exposure for both caregivers and patients. The company has even seen improved clinician satisfaction, in part because, “Our clinicians aren’t running all over the place.”.
CMS was granted the authority to temporarily lift existing Medicare program restrictions, allowing providers to offer a wider range of telehealth services. While Medicare may not reimburse for telehealth, opportunity knocks through Medicare Advantage (MA) plans. Prior to the emergency declaration in March, about 13,000 Medicare beneficiaries accessed telemedicine services during a typical week. That number jumped to more than 9 million beneficiaries having received a telehealth service between mid-March and mid-June.
The RCD is meant to thwart Medicare billing fraud and abuse on behalf of home health providers. The industry’s overwhelming feedback to the RCD has been that it amounts to a lot of paperwork and an undue burden. Home health agencies are also faced with adapting to the Patient-Driven Groupings Model (PDGM), which represents the biggest shift in home care reimbursement frameworks in the last two decades.
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