Literature Review

End-of-life care stakeholders celebrate end of hospice VBID carve-in McKnights Home Care, by Adam Healy; 3/6/24 Various hospice associations on Tuesday cheered the Centers for Medicare & Medicaid Services’ recent decision to abandon the Hospice Benefit Component of the Value-Based Insurance Design (VBID) model. ... Providers have long held that the uniqueness of hospice care, a multidisciplinary, person-centered care model, would make it a poor fit for MA. 

CMS offers relief to providers affected by Change Healthcare outageModern Healthcare, by Lauren Berryman; 3/5/24The Centers for Medicare and Medicaid Services has rolled out efforts to help providers navigate the Change Healthcare outage disrupting healthcare operations nationwide, the Health and Human Services Department announced Tuesday.Editor's Note: Access to the full article requires a subscription

Congress floats Medicare physician pay bump: 4 notes Becker's Hospital CFO Report, by Mackenzie Bean; 3/4/24 Physicians are set to receive a 1.7% increase in Medicare pay effective March 9 as part of a $460 billion spending package congressional leaders released this weekend. Four things to know: ... [click on the title's link for more]

Pharmacy associations join forces to advocate for pharmacists during change healthcare outageNewswire Press Release; 3/3/24 Association executives from the American Pharmacists Association (APhA), the National Community Pharmacists Association (NCPA), the National Alliance of State Pharmacy Associations (NASPA), and the American Society of Consultant Pharmacists (ASCP) released an open letter to pharmacy benefit manager (PBM) executives and other insurance payers whose systems may have been impacted by the Change Healthcare outage. Pharmacists and pharmacies are asking for assurances that claims fulfilled during this outage will be paid, and paid in a timely manner, considering the challenges faced by pharmacies and pharmacists with predicting co-payments and determining eligibility and coverage. 

Double your cybersecurity spending, CIO warns amid Change Healthcare attack Becker's Health IT, by Naomi Diaz; 2/29/24What does the Change Healthcare ransomware incident mean for healthcare organizations? Doubling your cybersecurity spending, according to one health system CIO. Will Weider, CIO and senior vice president of Wausau, WI-based Aspirus Health, shared five thoughts on LinkedIn Feb. 29 about the incident, saying, "Whatever you planned to spend to improve cybersecurity, double it." Additionally, Mr. Weider stated that in light of this incident, healthcare organizations should: ...

‘Playbook’ offers strategies for home health, hospice firms to jump into value-based care McKnights Home Care, by Adam Healy; 2/28/24 Don’t drag your feet. As entities like Medicare Advantage and Accountable Care Organizations continue to grow and thrive, the time is now for home care to step into value-based care, according to home care consultants at Transcend Strategy Group. “The next two or three years are going to be very critical,” Tony Kudner, chief strategy officer at healthcare consultancy firm Transcend Strategy Group, said in an interview Tuesday with McKnight’s Home Care Daily Pulse. “Now is the time to build out the larger organizational competencies that value-based care is going to require.”

Report of Hospice Election for Part D (Response File) U.S. Dept. of Health & Human Services - Guidance Portal; 2/26/24 The purpose of this Change Request (CR) is to define the response file related to CR 13202. [Click on the title's link and follow prompts to download the Guidance Document.]

False Claims Act - 2023 Year in ReviewJD Supra; by William Athanas, A. Lee Bentley III, Gene Besen, Ryan Dean, Jonathan Ferry, Daniel Fortune, Giovanni Giarratana, Ty Howard, Elisha Kobre, Anna Lashley, Gregory Marshall, Lyndsay Medlin, Stephen Moulton, Ocasha Musah, Scarlett Singleton Nokes, Cara Rice, Brad Robertson, Tara Sarosiek, Jack Selden, Erin Sullivan, Courtlyn Ward, Virginia Wright; 2/28/24As we do every year, this issue revisits the key cases and other developments from the year gone by. And by most metrics, 2023 was a notable year for the False Claims Act (FCA).

Chapters Health System CEO on prioritizing value-based care initiatives in the home Home Health Care News, by Andrew Donlan; 2/26/24Andrew Molosky, the president and CEO of Chapters Health System, is keenly aware of the struggles that coincide with turning a large health care provider organization into a value-based one. The first priority in that situation, in his mind, is making sure that the entire organization is on the same page in terms of what value-based care really means, he told Home Health Care News ... “You want to get to the point where you can manage populations in the home,” Molosky said. “That becomes a parlay to reducing ER spend in a full-risk environment. It becomes earlier intervention for a hospice or home health episode. 

MA may be worth the gamble: How agencies can win at a new game HomeCare, by Lindsay Doak; 2/23/24 Over the past decade, a major shift has occurred in the Medicare market that many of us didn’t see coming: the takeover of Medicare Advantage (MA). ... This is a true game changer for the home health and hospice industry. ... So, how can agencies successfully contract with MA plans, while ensuring their costs are covered? This is where I like to refer to the wise words of Kenny Rogers’ “The Gambler,” who said, “If you’re gonna play the game…You gotta learn to play it right.”

Centers for Medicare & Medicaid Services corrects rule involving 2024 home health prospective payment system rate updateCMS Federal Register; 2/21/24This document corrects technical errors in the final rule that appeared in the November 13, 2023 Federal Register titled “Medicare Program; Calendar Year (CY) 2024 Home Health (HH) Prospective Payment System Rate Update; HH Quality Reporting Program Requirements; HH Value-Based Purchasing Expanded Model Requirements; Home Intravenous Immune Globulin Items and Services; Hospice Informal Dispute Resolution and Special Focus Program Requirements, Certain Requirements for Durable Medical Equipment Prosthetics and Orthotics Supplies; and Provider and Supplier Enrollment Requirements” (referred to hereafter as the “CY 2024 HH PPS final rule”).

Ascension posts $708M quarterly turnaroundBecker's Hospital CFO Report, by Alan Condon; 2/19/24Ascension reported a net income of $359.5 million in the fiscal second quarter ending Dec. 31, which is a $708 million improvement on the $238.1 million net loss it reported during the same quarter in 2022. "We remain focused on improving hospital operations, ensuring sustainability for the future and making purposeful decisions that improve the health of individuals and the communities we are privileged to serve,"CFO Liz Foshage said. "Our Q2 quarterly results are a demonstration of this commitment and a signal that we continue to move in the right direction."