Literature Review

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

The current state of community-based palliative careHospice News, by Jim Parker; 3/4/24“Palliative care” is becoming a buzz word in health care, even if many people don’t understand the loosely defined term. However, wide variation exists in how different providers deliver these services in the absence of a standardized, national definition or a more concrete regulatory structure that includes quality measures, Logan Hoover, vice president of policy and public relations for the National Hospice and Palliative Care Organization (NHPCO), said at the Hospice News Palliative Care Conference in Tampa, Florida.

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]

Change Healthcare's temporary funding program 'not even a Band-Aid,' AHA says Becker's Health IT, by Giles Bruce; 3/4/24 The American Hospital Association called Change Healthcare's temporary funding program for providers affected by the cyberattack on the UnitedHealth Group subsidiary inadequate, while a U.S. Senate leader asked CMS to speed up payments to hospitals. Change Healthcare set up the funding assistance March 1 for providers facing cash-flow issues after losing access to its payer systems, which have been down since the Feb. 21 ransomware attack. However, AHA President and CEO Rick Pollack wrote in a March 4 letter to UnitedHealth Group that the program is "not even a Band-Aid on the payment problems you identify."

Home health disparities: Medicare Advantage patients receive fewer visits, worse outcomes Home Health Care News, by Patirck Filbin; 3/1/24Home health patients under Medicare Advantage (MA) plans have worse functional outcomes compared to traditional Medicare patients, likely as a result of receiving fewer visits, according to a new study.

CMS upends Medicare Advantage supplemental benefits data reporting for payers DLA Piper, by Daivd Kopans and Sua Yoon; 2/27/24 On February 21, 2024, the Centers for Medicare & Medicaid Services (CMS) issued new guidance via a memorandum to Medicare Advantage (MA) organizations, Program of All-Inclusive Care for the Elderly (PACE) organizations, and Demonstration Organizations (collectively, Plans) that upends how these Plans have been reporting (or not reporting) encounter information for their covered supplemental benefits. The guidance in the memorandum is effective retroactively to January 1, 2024. [In this article] is a Q&A explaining the top points of the guidance and highlight its impact on companies across industries.

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).

Palliative care startups require creativity, flexibility Hospice News, by Audrie Marton; 2/27/24 According to the World Health Organization, each year, an estimated 56.8 million people need palliative care. Worldwide, only about 14% of people who need this care currently receive it. ... Tiffany Hughes, chief operating officer of Texas-based PalliCare, found that the secret to a successful palliative care model is creating a continuum of care between home health and hospice for patients within the last 18 to 24 months of life.

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. 

Palliative Care market revenue to surpass USD 6.43 billion by 2028freePRnow; 2/27/24The global market for palliative care reached a value of USD 3.53 Billion in 2020 and is projected to experience a revenue Compound Annual Growth Rate (CAGR) of 7.8% throughout the forecast period. Factors such as an increasing emphasis on enhancing the quality of life for individuals facing life-threatening or debilitating conditions through the alleviation of pain and symptoms, the establishment of professional palliative care organizations, and the broader accessibility of advanced palliative care services worldwide are anticipated to propel market revenue growth in the foreseeable future.

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.”

New Jersey system gets historic 'A+' credit ratingBecker's Hospital CFO Report, by Alan Condon; 2/19/24Camden, N.J.-based Cooper University Health Care has earned an "A+" credit rating from Fitch Ratings after receiving two credit upgrades from S&P Global and Moody's since 2022. ... "Fitch's rating is another indicator that our focus on becoming an exceptional academic health system by managing our finances in a way that allows us to continue to grow to meet increasing demand from patients seeking the higher level of care our experts provide is the correct strategy," Cooper co-CEO Anthony Mazzarelli said.Editor's Note: Cooper University's Hospice and Palliative Medicine (HPM) Fellowship is an important component of their academic health system.