Legislative
- Health Care Reform (Members Only): The Patient Protection and Affordable Care Act has many opportunities and challenges for nonprofit home health and hospice. Below is key information on its various provisions including new programs, demonstrations and pilots.
- Home Health Co-Payment: Co-payment proposals are short-sighted and will result in cost shifting to patients or increased institutional care. Compared to alternative care such as skilled nursing or a hospital stay, home health is a third of the cost. Without necessary home healthcare, patients will require healthcare in costly institutional settings – at much greater expense to government and families.
- 2012 Budget Proposals: Read VNAA’s position and analysis.
- Case Mix Creep
Regulatory
- Face-to-Face (F2F) Physician Encounters: In the final rule, CMS extend the period of time in which the F2F encounter could occur to 90 days prior to, or 30 days after, the start of home health services.
- Home Health Proposed Rule for 2013 (Members Only): On July 6, the Centers for Medicare and Medicaid Services (CMS) released its proposed home health rule that would take effect for calendar year 2013. Consistent with practice over the past few years, this proposed rule includes both the usual payment update proposals and an assortment of other changes to home health and hospice rules, ranging from trivial to very significant.
- Fraud and Abuse: VNAA in conjunction with its members developed a white paper consisting of proposals to reduce the incidence of abuse in the Medicare program and enhance the quality of care agencies provide. VNAA began this project anticipating that the growth in reported abuse of the Medicare home health benefit would require action and that VNAA could and should take a leadership position.
- Provider Enrollment, Chain and Ownership System (PECOS) – Members Only: Physicians must have a record in the Medicare PECOS database by July 6, 2010, as stipulated in the Patient Protection and Affordable Care Act (PPACA). This provision was included to better track physicians and ultimately reduce fraud and abuse in Medicare. However, many physicians need to enroll, re-enroll or officially opt-out of PECOS to be compliant with this rule.
- Provider Enrollment, Chain and Ownership System (PECOS) – Limited Access: Physicians must have a record in the Medicare PECOS database by July 6, 2010, as stipulated in the Patient Protection and Affordable Care Act (PPACA). This provision was included to better track physicians and ultimately reduce fraud and abuse in Medicare. However, many physicians need to enroll, re-enroll or officially opt-out of PECOS to be compliant with this rule.
- Rural Issues: VNAA has been very active on rural and underserved health issues over the past year and will continue to be active in the coming year through the formation of a new interest group focused on helping rural home health and hospice members’ access opportunities through agencies like the Health Resources and Services Administration (HRSA) as well as network with each other.
- Home Health Value-Based Purchasing: Section 3006 of the Affordable Care Act requires the Secretary of Health and Human Services to develop a plan to implement a value-based purchasing program for payments to home health agencies under the Medicare program. The concept of value-based healthcare purchasing is that buyers should hold providers of health care accountable for both cost and quality of care. CMS is in the preliminary stages of developing a value-based purchasing program for home health, and has asked for input from the industry.
- VNAA Vulnerable Patient Study – Members Only: VNAA, in collaboration with the Center for Home Care Policy and Research of Visiting Nurse Services of New York, has completed a study that analyzed data on a range of patients that VNAA members treat and the costs associated with providing care to these patients.
- Read VNAA analysis on proposed home health rules. Members Only Access | Limited Access