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News Roundup: July 8, 2016

4 Features of the Home Health Agency of the Future

Published by Home Health Care News
By Tim Mullaney
July 8, 2016

People’s homes may well become the center of the U.S. health care system in the future. That’s because home health care is well-positioned to be a linchpin in efforts to meet the “triple aim” goals underlying Affordable Care Act reforms: improving patients’ care experience, improving the health of populations, and reducing costs.

However, for home health agencies to fulfill their promise and move into this central position, they need to recognize the current opportunities and develop needed capabilities. This was a take-home message of experts who spoke last week at an Alliance for Home Health Quality and Innovation (The Alliance) panel.

A nonprofit consortium of home health providers and other organizations, The Alliance has spearheaded a project known as the Future of Home Health Care. With research from Avalere Health and input gleaned from symposia that took place throughout 2015, the project has developed a framework that policymakers, providers, and other stakeholders can refer to, to help home health fulfill its potential in the evolving health care system.

While the complete framework is forthcoming in research to be published later this year, leaders of the effort shared some top-line principles at last week’s panel in Washington, D.C. Among the ideas under discussion was the “home health agency of the future.” These are some of the characteristics of a next-generation home health agency, according to Alliance board vice chairman and VNA Health Group President and CEO Steve Landers, M.D.:

1. Patient-centered. The home health agency of the future will put the patient and his or her needs and goals foremost, developing care plans accordingly.

2. Connected. Health care reform has created accountable care organizations (ACOs), bundled payment programs, and other new payment frameworks to encourage and incentivize different types of providers to collaborate more closely. As a result home health agencies already are connecting in new ways with hospitals, physicians, skilled nursing facilities, and others, be it through the new payment models, joint ventures, preferred provider agreements or other business arrangements.

“We see that connectivity happening to make it less wasteful, and a better, less fragmented experience [for the patient],” Landers said.

3. High quality. As health care providers across the continuum are forging these new connections, they want to partner only with other best-in-class organizations. This will winnow the field, meaning that home health agencies need to focus on quality to be successful in the future. This means adhering to evidence-based best practices, and leveraging all the data and analytics capabilities that are becoming increasingly available and sophisticated, to drive continuous quality improvement.

4. Tech-enabled. Technology will undergird efforts in nearly every realm of home health in the future. Connections with other providers will be facilitated with health information exchange and care coordination supported by mobile and digital tech. A particular priority should be using technology to fill the “white space” between home health in-person encounters with education, messaging, video encounters, and the like, Landers said.

A home health agency with these characteristics will be well-suited not only to provide high quality patient care, but to fulfill the more varied functions that home health likely will be called upon for, said Sally Rodriguez, director at Avalere Health.

These functions likely will include being more of a care manager, making the call as to what setting is most appropriate for a given patient at a particular time, as well as more diverse types of care, Rodriguez said. For instance, hospital-at-home programs already are bringing acute care into this setting, and home-based primary care also is on the rise.

Not every agency has to do all these things, but as an industry, the focus should be on expanding home health to encompass all these different dimensions, she said.

Agencies have work to do to build up these capabilities needed for the future, but for home health to fulfill its potential, policymakers also will have to step up, the panelists emphasized. One area policymakers should focus on, they said, is making it easier to activate Medicare’s home health benefit and providing more flexibility in what services it covers.

“Policymakers should think about ways to provide flexibility, especially in alternative payment models, maybe giving flexibility to the home health provider, or if not that, then the hospital or ACO,” Rodriguez said. “A key message is that we think there’s some meeting in the middle to happen.”

Guest Column: Home care for seniors a worthy investment

Published by The State Journal Register
By Vincent Speranza
July 8, 2016

This week, millions came together at barbecues, parades and fireworks displays across America to celebrate our Independence Day, and to reflect on the value of independence itself.

As a veteran and a senior citizen, the word independence holds a special meaning. I was proud to fight for the freedom and independence of millions around the world as a paratrooper in World War II. Now, as a retiree and senior citizen, I work hard to maintain my own personal independence. For me, independence means being able to live my own life in my own home for as long as I can.

But few fights for independence can be won alone. I get along pretty well for my age, but I do need help with some basics like preparing food, cleaning the bathroom — basic chores that I can't manage as easily on my own anymore. And I'm grateful every day for the home care workers who give me the support I need to live in my own home with dignity. I value their company and their friendship. And I know that if it weren't for them, I'd be forced to move to a nursing home — a circumstance I want to avoid as long as I can.

Unfortunately, my personal independence has become increasingly threatened by a year-long budget standoff between Gov. Bruce Rauner and the Illinois General Assembly. For more than a year, by refusing to sign a budget, the Rauner Administration imposed deep cuts on the home care services that I and about 75,000 other seniors rely upon to stay in our homes. These cuts have resulted in home care agencies shutting down, and many families scrambling to make other arrangements as they lose the home care workers who help seniors like me maintain active and independent lives.

Now, Gov. Rauner's administration is moving forward with more cuts to the program that makes my home care possible. Recently I've read that Gov. Rauner's planned cut to the Illinois Community Care program amounts to $197 million, which would translate to a 45 percent cut in funding for my own home care. That's the kind of cut that could cost many home care workers their jobs, and would cost me and tens of thousands of senior citizens like me our independence.

This isn't easy for me to write. I'm a conservative Republican. I was happy to cast my vote for our governor two years ago. I believe in fiscal responsibility, and that Illinois must tighten its belt to put our finances in order.

But cutting home care for seniors is penny wise and pound foolish. Nursing home care is much more expensive than home care, and forcing seniors to give up their independence and move into nursing homes will end up costing the hard-working taxpayers of Illinois more in the long run.

I'm urging all elected leaders in Illinois, Democrat or Republican, to take a stand for the independence of senior citizens across our state and oppose these cuts.
— Vincent Speranza was a paratrooper in World War II, where he was awarded a Bronze Star and Purple Heart. He lives in Auburn.

Report To Outline Strategies For Home Health Taking On Sicker Patients

Published by Inside Health Policy
John Wilkerson
July 8, 2016

Home health companies hope to take advantage of the coming performance-based physician pay system, but an unreleased Avalere Health report, which was highlighted Thursday (June 30), states that to do so they must improve their ability to care for new types of patients and show that home health companies can lower costs -- both of which increase costs for home health facilities. Home health providers said Medicare should pay for new types of services that home health companies could provide in order to save money in the long term by keeping patients out of hospitals and institutions, and they said CMS should waive some fraud-and-abuse-fighting measures for home health services that alternative pay models provide.

Read the full article here: http://insidehealthpolicy.com/daily-news/report-outline-strategies-home-health-taking-sicker-patients

Lawmakers Seek Easier Home Care Access With Medicare Proposal

Published by Bloomberg BNA
By Michael D. Williamson
July 8, 2016

•Sen. Markey, others introduce legislation to convert Medicare's Independence at Home pilot project into permanent program.
•Legislation to make program permanent is “being worked on for introduction in the House,” senators say.

July 6 (BNA) -- Certain Medicare beneficiaries would have easier access to health-care services in their own homes under bipartisan Senate legislation introduced July 6.

The Independence at Home Act of 2016 would convert the Centers for Medicare & Medicaid Services' Independence at Home (IAH) pilot project into a permanent, national program. Sens. Edward J. Markey (D-Mass.), John Cornyn (R-Texas), Michael Bennet (D-Colo.) and Rob Portman (R-Ohio) sponsored the bill.

Read the full article here: https://www.bgov.com/core/news/#!/articles/O9X2KJ3H0JK0