Literature Review

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."

Medicare Advantage complaints that the plans don’t want – and the review of systems that wasn’t done RACmonitor, by Ronald Hirsch, MD, FACP, ACPA-C, CHCQM, CHRI; 4/24/24 ... In the past, I have talked about complaining to your regional Centers for Medicare & Medicaid Services (CMS) office about violations of CMS-4201-F, but Dr. [Eddie] Hu described how to do it to actually get action. [Click on the title's link for details] ... Now, why should you take the time to file these complaints? ... Why should you take the time to file these complaints? Because CMS tracks formal complaints, and a lot of complaints can significantly affect their quality bonus – and we know how when their money is at risk, the MA plans suddenly pay attention. ...

CMS increases hours to 3.48 in final staffing rule McKnights Long-Term Care News, by Kimberly Marselas; 4/22/24 Nursing homes will be required to deliver 3.48 hours of daily direct care per patient under a final staffing mandate issued this morning. A White House statement on the rule [4/22] said that 3.0 hours must be split between registered nurses at 0.55 hours and 2.45 hours for certified nurse aides. The remaining time was not immediately defined by the White House release, and the full rule text was not available.

Increasing Hospice CAHPS scores through enhanced caregiver training Hospice News, by Jim Parker; 4/19/24 Improving education and training for family caregivers may give hospices’ quality scores a boost. Maryland-based Hospice of the Chesapeake has introduced a standardized caregiver training program designed to enhance the work they had previously done in this area. After a review of scientific literature, it became clear that nationally, caregiver training was spotty, and this affected families’ perceptions of the care their loved one received, Monica Ferebee, clinical manager of hospice at Hospice of the Chesapeake ... More than 70% of hospice patients are primarily cared for by untrained family caregivers with no medical background, Ferebee found. She led Chesapeake’s change project to address these concerns, and thereby improve performance on Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys. 

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.

Hospice handoffs may lower odds of Medicare denials Medscape, by Lara Salahi; 4/29/24Clearer communication between primary care clinicians and hospice providers may decrease the number of denied Medicare approvals for end-of-life treatment, according to a small study presented on April 18 at the American College of Physicians Internal Medicine Meeting 2024. Tyler Haussler, MD, acting medical director at  Brookestone Home Health & Hospice in Carney, Nebraska, said he conducted the study. ... CMS requires a "face-to-face encounter" between a physician and hospice caregiver to communicate clinical findings and determine the patient's terminal status. Missing or incomplete documentation of a patient's medical condition remains one of the main reasons the agency denies hospice coverage. 

Mississippi Capitol sees second day of hundreds rallying for ‘full Medicaid expansion now’Mississippi Today - Legislature; by Bobby Harrison and Geoff Pender; 4/17/24Hundreds of people rallied at the Mississippi Capitol for a second day Wednesday, urging lawmakers to expand Medicaid to provide health coverage for an estimated 200,000 Mississippians. ... Speakers recounted their struggles with access to affordable health care in Mississippi and chanted for the Legislature to, “Close the coverage gap now,” and for “Full Medicaid expansion now.” ... [Dr. Randy] Easterling recounted a story of two of his friends diagnosed with similar cancers. One was uninsured and self-employed, and did not get early diagnosis or treatment. He’s now in hospice and on death’s door. The other friend, with insurance, received an early diagnosis and treatment and is now cancer free.

In two states, transforming the model for palliative care [CA & HI]Undark, by Meredith Lidard Kleeman; 4/16/24 "Being ill is like a full-time job,” said Andrew E. Kaufman, a 60-year-old author. Kaufman lives with myasthenia gravis, a neuromuscular disease, as well as other chronic conditions, and his self-care requires a lot of time — and communication. The cascade of his own needs “is frustrating and causes anxiety and a whole host of issues.” Lucky for Kaufman, he lives in California, where he has help from a palliative care team. California is one of the first states in the country to require insurance companies that administer Medicaid benefits to fully cover palliative care services for eligible residents. Editor's Note: Click on the title's link to read more, as this use redefines "palliative care."

Potential CMS measure shows divide over quality training standards Modern Healthcare, by Mari Devereaux; 4/12/24 Hospitals may soon be required to provide set quality training to staff as part of a Medicare reporting program, but health systems and advocacy organizations are split on whether the standardization of quality-related skill sets is necessary to improve patient care.

New DOJ rules for online healthcare content make sure seniors aren’t taken offline McKnights Senior Living, by Aaron Dorman; 4/11/24The Department of Justice took steps earlier this week to help make sure old adults have appropriate access to valuable web content they need for understanding important healthcare and coverage decisions. State and government agencies, such as the Centers for Medicare & Medicaid Services, must abide by new technical standards, according to a new DOJ rule signed Monday [4/1/24]. “Just as stairs can exclude people who use wheelchairs from accessing government buildings,” the official rule states, “inaccessible web content and mobile apps can exclude people with a range of disabilities from accessing government services.” The technical requirements of the rule are extensive — the updated document is almost 300 pages long — but the overall purpose is to instruct agencies on their obligations to account for possible disabilities.

How MA Plan design affects utilization, health equity MedCity News, by Marissa Pescia; 4/8/24 A new study found that enrollees with zero-premium MA plans are three times as likely to be non-White compared to other MA enrollees and traditional Medicare enrollees. ... The study was published by Harvard Medical School and Inovalon, a provider of cloud-based software solutions. It used Inovalon’s Medical Outcomes Research for Effectiveness and Economics Registry dataset, which “tracks demographic characteristics and outcomes for about 30% of all MA members at any given point in time,” according to the report.

New patient safety measures imminent as risk of harm evolves: CMS McKnights Long-Term Care News, by Kimberly Marselas; 4/10/24 The Centers for Medicare & Medicaid Services remains acutely focused on patient harm and will introduce new measures addressing patient safety later this year, agency leaders said at an event in Baltimore Tuesday. ... Agency officials are working with other Health and Human Services branches and meeting internally to develop a 10-point patient safety strategy to be unveiled later this year.