Literature Review

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. 

How the FTC noncompete ban affects nonprofit providers Modern Healthcare; by Alex Kacik; 4/25/24 The Federal Trade Commission’s ban on noncompete agreements will apply to some healthcare nonprofits, lawyers said. ... In the final rule, the FTC offers an example of a nonprofit hospital that employed 100 physicians. The commission would have jurisdiction “because the organization engaged in business on behalf of for-profit physician members,” the rule states. ... The FTC created a carve-out for senior executives in the final rule. Existing noncompete agreements with senior executives, defined as workers who earn more than $151,164 a year and are in policymaking positions, can remain in place. But employers are barred from enforcing new noncompete provisions with senior executives.

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."

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:

What the ‘fundamentally contradicting’ Medicaid Access Rule includes Home Health Care News, by Andrew Donlan; 4/22/24 The White House teased the finalized Medicaid Access Rule early Monday, and the Centers for Medicare & Medicaid Services (CMS) later revealed more intricate details attached to the rule. [The] timeline of the rule is now clear. Specifically: ... [Click on the title's link for more]

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.

Summaries: FFY 2025 Hospice, Inpatient Rehabilitation Facility, Skilled-Nursing Facility Medicare Payment Rules California Hospital Association, 4/17/24 What’s happening: Summaries of the hospice wage index, inpatient rehabilitation facility (IRF) prospective payment system (PPS), and skilled-nursing facility (SNF) PPS proposed rules are now available.What else to know: Comments on the proposed rules are due by May 28. The members-only summaries, from Health Policy Alternatives, Inc., describe proposals for the post-acute care Medicare prospective payment systems for federal fiscal year 2025: 

One-third of West Virginians may soon have a harder time getting health care after lawmakers declined to fully fund Medicaid Mountain State Spotlight, by Erin Beck; 4/18/24Across West Virginia, it’s already hard for many people to access health care. And unless state lawmakers change the budget they passed last month, it’s about to get even more difficult, especially for people who live in the most rural areas and those considered lower income. Starting in July, at the start of the next fiscal year, West Virginia officials will be forced to dramatically cut the state’s Medicaid budget. Roughly one-third of the state’s population relies on the government health insurance program. ... [Lawmakers] gave the program about $150 million less than was needed. 

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.