The two organizations had already merged – and named a new leader – but had not yet announced a new name or brand.

The National Alliance for Care at Home (the Alliance) aims to provide resources, education and information to assist members in expanding their organizations. Additionally, the Alliance will serve as the collective voice of the member community, advocating for policies that promote the delivery of high-quality care for patients and their families.

The logo of the National Alliance for Care at Home pays tribute to the past while also representing the future. It combines visual elements that symbolize NAHC and NHPCO, the legacy organizations that have merged to form this new alliance. The logo concept was developed based on input from a workgroup of members, who have had a significant influence on the Alliance’s brand.

The Alliance The Alliance

The Alliance also launched its integration website today at AllianceForCareAtHome.org. The new site not only provides information on the organization, but also serves as a single sign-on hub for members.

The new website includes an updated “Find a Provider” tool to assist consumers in locating home care, home health, hospice and palliative care providers. In the upcoming weeks, Alliance members will have access to a total of 29 online member communities, facilitating the professional exchange of ideas and best practices. A new website is set to launch in 2025 at the current URL, consolidating the key features from both NAHC and NHPCO’s legacy sites. Throughout the development of the new site, the Alliance’s integration site will act as a gateway to access resources from the two legacy sites.

“Providers offering various forms of care at home have always looked to our national associations to help create a shared vision for the future,” Kenneth Albert, chair of the Alliance’s transition board, said in a statement. “It took imagination, dedication and guts to take on the tough conversations about combining two organizations, each with more than 40 years of history. This Alliance will be the leading authority on transforming care in the home. We will implement that mission under a new name that welcomes providers across the care continuum to join–the National Alliance for Care at Home. The logo shows people coming together, hand in hand. That is exactly what we will do in this new Alliance–work collectively to imagine what the future of care in home settings can and should look like, and then to bring that vision to reality.”

In March 2023, NAHC and NHPCO announced they were exploring collaboration opportunities. This initiated a member consultation and input process which led to an agreement to combine the two organizations into a new Alliance, with integration work beginning July 1, 2024.

On Aug. 26, the Alliance announced that Dr. Steve Landers would become its first CEO. The Alliance will continue integrating NAHC and NHPCO operations into a single organization through the remainder of 2024 and into 2025.

The post NAHC, NHPCO Merger Becomes ‘National Alliance for Care at Home’ appeared first on Home Health Care News.

In home care, turnover tends to beget more turnover. If providers don’t nip the issue in the bud, they will open themselves up to a larger problem.

Home care agencies report average turnover rates of 76%, which challenges their ability to deliver high-quality services. High employee turnover also means high financial costs. On average, caregiver turnover costs agencies $171,600 annually, a report from Activated Insights showed.

Turnover results in extra hours for the remaining staff caring for clients, often leading to burnout. This also negatively impacts clients, as they don’t always receive the necessary attention due to the limited number of staff.

“These agencies are competing in a broad economy, and there are numerous job opportunities available for workers across various sectors,” Joanne Spetz, director of the University of California San Francisco Health Workforce Research Center, told Home Health Care News. “Licensed nurses are in high demand in hospitals and ambulatory care settings, while direct care aides and assistants with valuable interpersonal and organizational skills can find opportunities in many different sectors of the economy. As a result, there is significant competition for workers.”

Spetz stated that while health care organizations have revenue limitations, particularly in Medicaid or private pay, the significance of work culture in tackling burnout and retention should not be underestimated.

“Often, direct care workers, aides, and assistants are treated as disposable and unskilled, despite having valuable skills that should be appreciated,” Spetz stated. “Home care organizations need to find ways to show respect and appreciation for these workers, and create avenues for them to take on leadership roles, even if they may not be able to offer competitive wages.”

Spetz used the example of Washington State’s Medicaid program, which set up basic training standards and options for caregivers to follow. In this program, pay raises are linked to specific stages in the training options, allowing caregivers to receive formal recognition for their increasing skills and expertise.

Similarly, Austin State Hospital in Texas employs peer providers who are not licensed therapists, but peers who have experienced the same illnesses as some patients. The hospital recognized their contributions and began a career ladder process to move them into other opportunities in the organization. Spetz suggested the same idea could be implemented in home care organizations.

“It’s not all about compensation,” National Association for Home Care & Hospice (NAHC) President William A. Dombi told HHCN. “It’s about worker respect. It’s about people understanding that meaningful work is being done. It almost seems we’ve got a culture change that is developing within home care employment practices, recognizing that once you have someone employed, you must take steps to ensure you can keep them as an employee. Turnover rates are high, mainly because it seems everyone was spending time on recruitment and not enough time to focus on the retention side of the equation.”

Caregivers frequently face high levels of stress due to demanding job responsibilities, unpredictable work conditions and feelings of isolation. These stressors can lead to low job satisfaction and emotional burnout, ultimately causing caregivers to resign from their positions.

“We are aware that factors such as burnout and low compensation contribute to turnover,” Molly Candon, assistant professor in the Center for Mental Health and the Department of Health Care Management at the University of Pennsylvania, Philadelphia, told HHCN. “We also know that characteristics of home health care organizations, such as the quality of supervisory feedback and long work hours, can drive turnover.”

Caregivers value work-life balance and seek assurance that their jobs are not a dead end. They want the chance to develop and grow within the organization. Thus, continuous and thorough education and training can improve staff retention. Training prospects and internal advancement opportunities are crucial for attracting new employees. Candidates are more inclined toward employers who provide them with opportunities for improvement and progression.

For some caregivers, the idea of shift or client assignments helps with burnout and gives them a sense that they are making a difference and offering the best care to their clients by providing continuity.

“Clients and staff generally seem to want continuity of relationships,” Spetz said. “Caregivers want to know, whenever possible, they are going to get a certain client on Monday, Wednesday and Friday and a different client on Tuesday and Thursday, for example. That creates predictability and a sense of routine that can help with burnout and work-life balance.”

For agencies experiencing high turnover, checking in with caregivers can be a great way to understand what they need to feel valued.

“Exit interviews are important, but I would suggest retention interviews,” Spetz said. “When someone has been with your team for a while, interview them to find out why they are staying and what they like about the job or your organization.”

Condon echoed the necessity of interviews, but also acknowledged they can sometimes be challenging to facilitate.

“Surveys and exit interviews are great resources for understanding why and how employees leave their position and could contribute to a root cause analysis,” Condon said. “However, employees need to feel comfortable disclosing their true intentions.”

The post How To Retain Employees And Combat Home Care Worker Fatigue appeared first on Home Health Care News.

Landers is the former CEO of the Visiting Nurse Association (VNA) Health Group, a nonprofit home health, hospice and palliative care operator that serves patients in Ohio and New Jersey.

He left the company last year and became the president and CEO of Hebrew SeniorLife, a Harvard Medical School-affiliated senior living provider that is also a research and educational organization. After nearly a year there, Landers opened up his own venture, Landers StratAGEy, in May of this year.

Now, he’ll be tasked with leading the NAHC-NHPCO Alliance, which is set to have a new name itself in the coming months. NAHC and NHPCO began integrating on July 1, and together are the largest home-based care advocacy organization in the country.

NAHC President William A. Dombi has been a part of the transition, and is set to retire at the end of the year.

“The Alliance members provide a wide range of high-quality home- and community-based services that promote comfort, dignity and independence,” Landers said in a statement. “I’m so proud to become a part of this organization, and am eager to serve. I’ve had the opportunity in my career to see the health care industry from many vantage points, and in this new role with The Alliance, I will use all that I have learned to make a difference for our members as we continue to expand to meet the growing public needs for our care.”

Outside of his time at VNA Health Group and Hebrew SeniorLife, Landers also spent time at the Cleveland Clinic and at John Hopkins School of Public Health.

“Providing leadership around policy and advocacy efforts is critical to our mission at The Alliance,” Transition Board Chair Ken Albert – who also serves as the CEO of Andwell Health Partners – said in a statement. “Throughout his career, Dr. Landers served the field as an effective policy advocate, shaping policy at both the state and federal levels. We are thrilled to welcome him as our inaugural CEO, and I know he will build an extraordinary team to offer value for our members.”

Landers is a logical fit given his extensive experience in all service lines related to home-based care.

“Dr. Landers’ rich and diversified experience makes him the ideal candidate to lead our membership as our organization evolves,” Alliance Transition Board Vice Chair Melinda Gruber added. “Working alongside community health workers and within our patients’ homes, he understands what we need as frontline caregivers and advocates.”

The post NAHC-NHPCO Alliance Names Dr. Steve Landers As Inaugural CEO appeared first on Home Health Care News.

The news comes just two days after the home health proposed payment rule was released, which included significant cuts for the third straight year.

Broadly, moving away from the Chevron precedent – usually known as the Chevron doctrine – will mean less regulatory power for government agencies. Government agencies often take their own interpretations of certain laws and statutes, and then act upon those interpretations. Moving forward, it’s likely that these agencies will need more explicit direction from Congress to regulate on firm standing.

The reaction to the Supreme Court decision has mostly been centered around issues like the environment and reproductive rights.

But the decision could also be the breakthrough that home health providers needed to stop – and potentially undo – payment cuts. This week, CMS proposed a 1.7%, or $280 million, decrease to aggregate home health payments for 2025. The final rule is expected in late October or early November.

The National Association for Home Care & Hospice (NAHC) already filed a lawsuit against the U.S. Department of Health & Human Services (HHS) and CMS over rate cuts in 2023.

“In our own analysis, we believe that providers of home health have been underpaid as it relates to budget neutrality,” NAHC President William A. Dombi said when the lawsuit was filed. “At minimum, we would expect to see the rate cuts from 2023, that were permanent readjustments to the base rate, and the one proposed for 2024, along with the temporary adjustments … to go away. The end product of that is that we would have a stable system to deliver home health services to Medicare beneficiaries.”

NAHC has now re-filed that lawsuit, after it was initially dismissed by a federal court.

Even before Chevron was officially overturned, there was evidence to suggest that the Supreme Court was moving away from its line of thinking. The first was in West Virginia v. Environmental Protection Agency (EPA), where the court undercut the EPA’s power in restricting carbon dioxide emissions.

In a health care context, it showed up in American Hospital Association v. Becerra, which was similar to the current NAHC lawsuit.

Like West Virginia v. EPA, the AHA v. Becerra case went the opposite direction of the Chevron precedent.

Prior to 2020, CMS proposed a series of policy changes for hospitals, one of which would have reduced payment, specifically through the 340B drug pricing program. For context, 340B hospitals are generally those that serve lower-income or rural populations.

The 340B cuts represented at least $1.6 billion in lost revenue annually for hospitals.

Like NAHC will with home health cuts, the AHA argued those cuts would hurt patient care, and that CMS did not have the power to levy those cuts in the first place.

In 2022, the Supreme Court ruled unanimously against HHS and CMS in that case. It was later ruled, too, that CMS pay hospitals back for the underpayments, with interest.

“The Supreme Court basically said the law requires certain actions to be taken by CMS in setting the hospital rates as it relates to the 340B, and they had two ways to go. And CMS chose not to go those two ways,” Dombi told HHCN in 2022. “What we’ve got going on in the home health payment rule is a comparable legal argument that starts with the position that the law does not allow CMS to do what it did do on the budget neutrality methodology. And second, that the law requires a specific set of actions, none of which the CMS methodology complies with.”

Home health advocates have lobbied against CMS cuts through public comments during the time between the proposed and final rules. They’ve provided data and storytelling to do so. They’ve also successfully lobbied lawmakers to introduce the Preserving Access to Home Health Act in both the Senate and the House, but that legislation hasn’t moved forward in past years.

A lawsuit was not the desired outcome for NAHC, but one of its last options. Now, that lawsuit may have more wind behind its sails.

“It improves the chances of success for our lawsuit going forward,” Dombi told HHCN Friday, regarding the Chevron decision. “It also means Congress is going to have to offer more detail in its legislative language, leaving less to the administrative agency to bring in interpretations. That, in many ways, is a good thing too.”

The post How The Supreme Court’s Chevron Decision Could Help Stop Home Health Cuts appeared first on Home Health Care News.

In the last home health proposed rule from the Centers for Medicare & Medicaid Services (CMS), the federal agency in charge of reimbursement rates sent out a request for information on home health aide utilization.

Specifically, the agency wondered why Medicare-covered home health aide visits and utilization had fallen off a cliff over the last few decades.

According to the Center for Medicare Advocacy, home health aide visits declined by 90% from 1998 to 2019.

Many people who work in and around home health were surprised by the CMS request, believing the agency itself was one of the main culprits.

“When we saw that go into the proposed rule, we laughed out loud,” National Association for Home Care & Hospice (NAHC) President Bill Dombi told Home Health Care News.

Home health aide history

In 1987, Dombi took part in a class action lawsuit on behalf of NAHC and home care patients against the Medicare program. There were a whole host of issues within the lawsuit, Dombi recalled, but one of them had to do with the accessibility to home health aide services.

The lawsuit was successful, and created a standard that ultimately found itself into the statute itself.

“Congress modified the law to pretty much codify the outcome of the lawsuit,” Dombi said. “It set a standard that an individual could qualify for 28 to 35 hours a week of home health aide services within the definition of part-time or intermittent care — which had been the part of the statute that I litigated around.”

At that point in time, home health aides services were the primary discipline of care that people were receiving for services — more than even nursing care.

Then, two things happened. In the Balanced Budget Act of 1997, Congress eliminated blood draws from the list of benefits that could qualify a person for the home health aide benefit.

That dilution of the benefit was compounded by a major change in the reimbursement model for home health services — the Interim Payment System.

This system aimed to change the way Medicare paid for home health services. Instead of paying providers based on the costs they incurred, Medicare transitioned to a prospective payment system.

Under the IPS, Medicare made fixed payments to home health agencies based on the patient’s condition and the services needed rather than reimbursing them for the actual costs of care. This change was intended to control costs and improve efficiency in the Medicare home health benefit.

“It devastated home health agencies and home health services,” Dombi said. “Forty percent of home health agencies shut down within an 18-month period of time. The volume of patients served in the Medicare program went from 3.5 million to 2.1 million in that same 18-month period of time.”

Prior to the IPS, agencies received more reimbursement for the more services they provided. With IPS, agencies had a cap on what would be payable.

“That really chilled the providers’ willingness to take on patients that had high levels of home health aide services,” Dombi said. “Because it raised the level of payment, but you then hit against the cap. And when you hit the cap, you didn’t get the payment.”

When the Prospective Payment System (PPS) system was implemented in 2000, home health aide services were already dwindling.

The episode of payment for home health services is around $2,000 for 30 days worth of care. Adding 30 days of home health aide services — at an average of about four hours a day — would add between $3,000 to $4,000 to the cost of care, Dombi estimated.

“You can’t expect a home health agency to get paid $2,000 to deliver $5,000 to $6,000 worth of care,” he said. “As an existing care provider, they would last a nanosecond if they started doing that. So at the moment, it’s all reimbursement related.”

That brings the timeline to 2023 when CMS essentially asked, “Why are home health aide services so difficult to get for patients?”

CMS and provider disconnect

CMS received nearly 100 comments that highlighted a number of challenges that all had a similar tone: the decline in utilization is not reflective of the need of home health aide services.

Commenters noted that despite Medicare laws allowing for substantial aide hours, the actual provision is dwindling, affecting patients who require a combination of skilled and aide services for optimal health and safety at home.

One commenter noted that CMS’ episodic reimbursement for home health does not adequately support robust staffing, particularly in rural areas. This creates a situation where agencies may struggle to justify separate visits by home health aides when nurses or therapists can perform similar functions within their scope of practice during skilled or therapy visits.

The biggest detractor, as Dombi pointed out, is payment.

“We’ve always provided home health aide services to clients,” Vince Moffitt, president and CEO of Basin Health Companies, told HHCN. “However, due to a reduction in reimbursement rates over the years, these services have been something that we have had to limit. It boils down to decreased reimbursement rates. Our operational costs continue to increase and our episodic payments can’t support extra services.”

Basin Health’s portfolio includes Basin Home Health & Hospice, a New Mexico-based provider with 700 employees. It serves the rural communities in the Four Corners area.

One of the more disappointing aspects of having to scale back offering those services is the inherent trust that is built between client and home health aide.

“By facilitating activities of daily living multiple times a week, home health aides provide both physical support and emotional comfort during a vulnerable time,” Cleamon Moorer Jr., president and CEO of American Advantage Home Care, told HHCN in an email. “Their regular presence often serves as a lifeline, improving mental health through meaningful companionship.”

American Advantage Home Care provides skilled nursing, rehab and specialty care services in seven counties in the Southeast Michigan area.

There are also insurer and payer hangups when it comes to home health aides. Not all insurers cover home health aide visits, Moorer pointed out, stifling reimbursement for agencies.

“I may speak for many of us in the industry as we strive for a reimbursement increase that fairly aligns with the input from a cross-section of our Medicare cost reports’ data,” Moorer said.

Many commenters writing to CMS highlighted concerns that the PDGM payment model discourages agencies from employing aides and providing necessary services — especially for patients with high functional impairments and multiple comorbidities.

“Home health aides spend a lot of time with the patients due to the type of services they provide,” Moffitt said. “This allows them to help ensure that the patient is safe and following the plan of care. It also helps the clinician with their care due to the extra eyes and time with the patient.”

Which, as Moffitt pointed out, improves outcomes — something CMS has beaten the drum for in recent years.

What now?

When CMS asked for information, agencies weren’t shy about what needs to happen in order for home health aide utilization to get back on track.

Commenters urged CMS to overhaul the current reimbursement compensation to better incentivize the provision of home health aide services. One suggestion included establishing a new payment mechanism specifically designed to ensure fair compensation for home health aides that would reflect the critical nature of their role and their impact on patient care.

Moorer echoed some of those ideas.

“There should be clearer career pathways and support for home health aides who desire to ascend the clinical career ladder,” Moorer said. “More specifically, financial incentives for employers who are agile and flexible enough to support the educational pursuits of their home health aides.”

A lot of times, it comes down to more resources for agencies that will allow more flexibility.

“The solution is complex,” Moffitt said. “We have increased labor costs for all employees and vendor costs have increased. Along with fuel, utilities, supplies… If the episodic rate is increased it would be easy to use those additional resources for those needs.”

Moorer said that mandated reimbursement for authorized home health aide visits, regardless of the insurer, should be considered.

CMS did respond to these comments in the final rule.

“CMS appreciates the valuable feedback received regarding home health aide service utilization, coordination between Medicare and Medicaid, physician care plans, recruitment and retention challenges and wage disparities,” it wrote in the rule. “The comments and suggestions provided by stakeholders will help guide CMS’s efforts to enhance home health policies and optimize access and quality of care for Medicare beneficiaries.”

For Dombi, the response felt insufficient.

“I thought they continued to dodge the real question,” he said. “And if anything, they’re trying to shift the blame away from themselves and Congress. Because it’s not just CMS who is responsible for all of this. Congress took serious cuts to home health care. Back in ‘97, the Congressional Budget Office estimated it was going to be a reduction of $16 billion over five years in terms of spending. It worked out to be almost $70 billion.”

The post Untangling The History, Causes Behind The Precipitous Home Health Aide Utilization Drop appeared first on Home Health Care News.

One profession that is not on that list is an occupational therapist.

However, a new proposed bill could change that.

The Medicare Home Health Accessibility Act — which has bipartisan support — would establish occupational therapy (OT) as a qualifying Medicare home health benefit and would allow occupational therapists to open home health cases.

“It’s been a long time coming,” Cindy Krafft, owner of consulting firm Kornetti & Krafft Health Care Solutions, told Home Health Care News.

OT in home health

Occupational therapy in home health care generally focuses on helping people regain independence in activities of daily living (ADLs). Oftentimes, that process includes hands-on techniques, therapeutic exercises, functional activities and education to help a patient improve their physical and cognitive functioning.

It’s been over 40 years since occupational therapy was a Medicare qualifying service under the home health benefit.

In the early ‘80s, the Carter Administration brought OT services into the Medicare home health benefit, only for it to be taken out soon after by the Reagan Administration. Since then, advocates for occupational therapy in the home have been fighting for it to be included — with little success.

It’s difficult to calculate the volume of new patients the new piece of proposed legislation would bring to the space, Dombi said, but any spike in new patients is good news for providers.

“It certainly would bring value because OT is a very important part of the multidisciplinary team that can care for patients at home,” National Association for Home Care & Hospice (NAHC) President Bill Dombi told HHCN. “You can hit occupational therapy if it is along with another one of the two therapies — physical and speech language pathology — or as a continuing need when the other therapies are not being provided.”

Occupational therapy has been cast aside and treated like a non-core element of home health, Dombi added.

“There’s no other part of the Medicare program where occupational therapy is given a second-tier status,” he said. “It’s very difficult to rationalize why occupational therapy is not a qualifying skilled service to begin with.”

A shift in thinking

Prior to the pandemic, occupational therapists were not allowed to start any kind of assessments for home health cases. That changed slightly in the years following. As of January 2022, OTs were allowed to perform start-of-care assessments for therapy-only referrals.

However, for a patient to be admitted into home health services for therapy only, physical, speech therapy or both services must also be ordered.

The added flexibility offered by the U.S. Centers for Medicare & Medicaid Services (CMS) was a welcomed development for home health agencies, Krafft said.

“I think the pandemic and the flexibilities around that gave OT an opportunity to step into that space — apart from trying to get legislation changed,” Krafft said. “We’re approaching it now with a body of evidence that shows that having OTs admitting patients, being more involved at that qualifying criteria level, didn’t cause chaos. It didn’t cause an explosion in home health aide visits — which I think historically was one of the arguments against this.”

In fact, home health aide utilization has continued to fall, largely because of a reduction in reimbursement rates for home health agencies.

The proposed bill is coming at a good time, Krafft said.

“I think it has the best shot that I’ve seen in a long time,” Krafft said. “During the pandemic, when some of the rules got lessened to try to manage that situation, it didn’t cause ridiculous aide spikes. It didn’t cause OT to quadruple. It didn’t cause any of the things I think some folks were concerned about. That adding a qualifying service was going to exponentially increase costs. It’s almost like they got a live demo.”

The bill’s benefits

Allowing occupational therapists to start a home health case has several benefits, both from an agency’s point of view and the patient’s.

“[This bill] gives physicians, clients and home health agencies an opportunity to really elevate how they’re delivering care,” Alyson Stover, president of the American Occupational Therapy Association (AOTA), told HHCN. “At a time when we know there are staffing shortages, burnout, long drives in between different home health clients. When we can utilize each professional to its full capacity, then we can actually eliminate or reduce some of those barriers.”

It’s never made sense to Stover and other stakeholders that OTs — who are autonomous health care practitioners who can deliver an OASIS assessment, develop goals and make recommendations — don’t have the ability to open a home health case.

There are also unique skills occupational therapists have that others may not. .

“We are the professionals that know how to — and are trained in — evaluating the person,” Stover said. “Most of my colleagues have specialized training in environmental assessment modification, so it makes sense in a home health experience for us to have this opportunity. It makes sense for us to be able to go in and really facilitate, not just plans for the patient to be able to be more successful in their home, but for their home to be more successful to accommodate the patient.”

Stover also pointed to an independent study done in 2016 that showed when you spend more money on occupational therapy in the acute care setting, hospital readmissions are reduced.

That’s significant to home health agencies that are trying to reduce costs, improve their reimbursement rates under the Patient Driven Groupings Model (PDGM) and improve outcomes.

“This is going to be able to facilitate new opportunities in which we can develop protocols and to trial PDGM under a more health care-driven model,” Stover said. “Instead of a situation where we’re saying, ‘Hey, whoever can get in there, and let’s try to work with what we’ve got in these 20 visits.’ Let’s go ahead and see what happens when we put the occupational therapist in there first and then that can alleviate the stress on nurses and other professionals in the space.”

The post The Path For Occupational Therapy To Lose Its ‘Second-Tier’ Status In Home Health Care appeared first on Home Health Care News.

A number of changes went into effect on Jan. 1, and several of them will affect home health agencies.

Here’s what home health agencies should know about those changes.

Active enrollment, location changes

Starting this year, CMS will impose stricter reporting requirements for home health agencies and other providers as it pertains to changes in ownership, control and practice locations.

“This could be significant,” Mary Carr, VP for regulatory affairs at the National Association for Home Care & Hospice (NAHC), said during a webinar Wednesday. “CMS is going to require that all providers and suppliers report within 30 days a change in practice location. Prior to this change, home health and hospice agencies had 90 days to report a change in practice location. The definition includes additions and deletions of a practice location, so if you’re an organization that’s doing a lot of changes in your locations, adding locations, deleting locations — you’re going to want to pay attention to this, because you have a much narrower timeframe with which to report.”

These changes, according to CMS, aim to improve transparency and ensure timely notification of significant events that may impact the delivery of services.

If a home health provider changes who owns or controls the agency — or if there are changes in key officials responsible for its operation such as CEOs or managers — the agency must notify Medicare within 30 days.

Revocation of enrollment

CMS is also changing the rules around the revocation of enrollment in the Medicare program for providers, and added more reasons for revoking a provider’s enrollment in the Medicare program.

More specifically, CMS added language for cases related to noncompliance and violations of the False Claims Act (FCA).

“CMS has added this because they maintain that they do not have the authority to revoke a provider’s billing privileges simply because they have a judgment against them under the False Claims Act,” Carr said. “They felt that has very much handicapped them, because they have not been able to go after some individuals who defrauded the program as early as they would have liked to. They are now codified into regulation — very specifically — that if you are a provider that has a judgment against you under the False Claims Act, you could be revoked for that solely.”

CMS also added revocation rules for providers who have outstanding debts referred to the U.S. Department of Treasury.

The wording of the rule, Carr pointed out, has been changed from “has an existing debt” to “failed to repay a debt.” This suggests that revocation may occur not only for providers or suppliers with existing debts, but also for those who have failed to fulfill their repayment obligations within the required timeframe.

Deactivation

CMS has the authority to deactivate the Medicare billing privileges of a provider or supplier if they fail to submit any Medicare claims for a certain duration. This rule emphasizes the importance of maintaining active engagement with the Medicare program by regularly submitting claims for reimbursement.

The previous version of the rule stated that agencies must file claims within 12 months to make sure it stayed in the Medicare program. Now that threshold is 6 months.

This means that if a provider or supplier goes without submitting any Medicare claims for six consecutive calendar months, their billing privileges may be deactivated.

“CMS recognizes that there are legitimate providers that do not bill Medicare even though they are enrolled,” Carr said. “For example, a home health agency that only serves Medicaid patients but has to be enrolled in Medicare because the state requires it. They recognize that. But they also recognize that this is an indicator of fraudulent behavior — when a provider enrolls but never bills. That’s the rationale behind that.”

Carr said NAHC is taking the stance that it hopes CMS does not apply this rule broader than it’s been applied today.

“CMS says if you were not at risk for losing your billing privileges under the 12-month rule, you will not be under the six month rule,” Carr said. “CMS is not intending to try to deactivate more valid providers, they’re trying to catch more fraudulent providers more quickly. It bears watching and we certainly will because the reactivation process is not a simple process.”

The post What Home Health Providers Need To Know About CMS’ Medicare Enrollment Changes appeared first on Home Health Care News.

The new board will oversee the transition to a new, consolidated organization if, and when, the merger is completed. The merger is expected to be completed in 2024.

The transition board includes 20 members with a wide variety of experience in the home-based and post-acute care spaces.

“Across the continuum of serious illness care, providers are looking to the future working to ensure we can continue to provide high-quality, patient-centered care even as patient needs and payment models shift,” Melinda Gruber, proposed vice chair of the transition board, said in a statement. “The association representing providers should be similarly future-focused. This proposed transition board is the right group of people at the right time to take NHPCO and NAHC into the future to continue providing value for our current and future members.”

Melinda Gruber is the vice president of Corewell Health.

In October, NAHC President William A. Dombi announced that his organization and NHPCO were planning to merge. The plan came with what Dombi described as an “aggressive timeline,” hoping the merger would be done by 2024.

From now until the potential merger, NAHC and NHPCO will be operating business as usual and will work as two separate entities. If the merger is finalized, the two will then integrate their businesses together and will work on a combined strategy that will be put in place for 2025.

As far as Dombi’s future with the association, he is expected to stay on board through 2024 to see through the potential merger. After that it is still up in the air.

“The intention is that I’m here through 2024,” Dombi told HHCN in October. “With an expectation that, assuming we come together somewhere in the middle of the year, then I’m there in the role of the new organization as the president emeritus. Something like that.”

The organizations have been moving forward under the guidance of a steering committee made up of members of both NAHC and NHPCO, with support from the consulting firm McKinley Advisors.

“This proposed transition board is made up of experienced veterans of the care at home community, who possess the vision to understand both the opportunity and obligation to build an even stronger future for our sectors of the American health care delivery system,” NAHC’s board chair Ken Albert said in a statement. “Fulfilling our pledge to return the home to the center of American health care will require a new organization with the expanded expertise of both NAHC and NHPCO. I am very confident that this talented group of leaders is up for the challenges ahead, and that our collective focus will remain on the needs of our members as they endeavor to meet the demands of providing high-quality health care.”

Albert is currently CEO of Androscoggin Home Care + Hospice, as well as board chair for NAHC.

Proposed members of the transition board include:

• Ken Albert, CEO, Androscoggin Home Healthcare + Hospice (transition board chair)
• David Causby, CEO, Gentiva
• Trisha Crissman, interim president and CEO, CommonSpirit Health at Home
• Melinda Gruber, vice president, Corewell Health (transition board vice chair)
• Demetress Harrell, CEO, Hospice in the Pines
• Susan D. Lloyd, president and CEO, Delaware Hospice, Inc.
• Tarrah Lowry, COO, Trustbridge / Empath Health
• Christine McMichael, executive director, Hospice & Palliative Care Federation of Massachusetts
• Mark Morse, CEO, Enclara Pharmacia
• Mary Myers, retired president, Johns Hopkins Home Care Group
• John Olajide, CEO, Axxess,
• Bob Parker, chief clinical officer, Kindful Health
• Susan Ponder-Stansel, CEO Alivia Care, Inc.
• Sara Ratcliffe, executive director, Illinois HomeCare & Hospice Council
• Lynne Sexten, CEO Agrace Hospice and Palliative Care (transition board secretary)
• William Simione, CEO SimiTree, (transition board treasurer)
• Jennifer Sheets, NAHC board member, former CEO, Interim Healthcare, Caring Brands International
• Beth Slepian, president and CEO, Granite VNA
• Dave Totaro, chief government affairs officer, BAYADA Home Health Care
• Nick Westfall, CEO, VITAS Healthcare

The post NAHC, NHPCO Announce Transition Board Ahead Of Potential Merger appeared first on Home Health Care News.

Knowing that the weather won’t always be perfect is the first step in being prepared for whatever comes next in home-based care.

“For those of us who’ve been involved in health care services at home for a number of years, we have seen this evolution,” National Association for Home Care & Hospice (NAHC) President William A. Dombi said. “We’ve witnessed it. We’ve instigated it. There was a dream some decades ago to make home care not only mainstream, but to make it the center of health care services at home. We’re not exactly done with that journey yet, but we’re getting much, much closer.”

At year end, Dombi is encouraged by the infiltration of technology in the home, as well as major retailers and other big box companies investing heavily in at-home care. Emerging models, such as hospital-at-home and SNF-at-home, are in the early stages of evolution – but also show promise, he believes.

On the flip side, continued consolidation in the space and ongoing workforce challenges could cloud the skies in home-based care in 2024 and beyond.

Clear skies

Some of the most encouraging news for home-based care providers today is that the line that was drawn between what can happen in the home and what can’t has been sufficiently blurred.

“We can reference everything from home dialysis, home chemotherapy, home infusion,” Dombi said. “We can go back decades and remember those conversations where we asked, ‘Where’s the line drawn between a level of care and the site of care?’ That line has pretty much been obliviated.”

For providers looking to sustain success moving forward, investing in these innovations and collaborating with partners that are experts in their fields will be crucial.

A lot of that innovation is derived from name-brand companies that are relatively new to the space.

“There are major players focused on home health care support — both for self-care and for tools for professionals,” Dombi said. “Best Buy’s Geek Squad is now, at this very moment, traveling from one person’s home to another and setting them up for a hospital at home or remote patient monitoring approach to services. All the other big tech creators out there are focusing on what seems like two things: electric cars and care in the home. That’s an indication of what the future certainly may look like.”

Dombi made sure to point out that companies like Best Buy (NYSE: BBY), CVS Health (NYSE: CVS), Walgreens Boots Alliance (Nasdaq: WBA) and others usually don’t invest in things that don’t pan out.

“Those organizations do not invest in game-changing technologies unless they think that game will pay off,” he said. “Your action plan as providers: stay aware of this and be intrigued by it. Be mystified by some of the things that can happen, but also start looking at yourself on how your organization funds technology improvements and how you make those investments.”

Partly cloudy

Some cloudiness does exist, however.

“We do not have a stable concept of what a design or delivery model should look like,” Dombi said. “Which is a good thing. Being able to innovate and try things to see what works, and to make them even better after that, is a good place to be.”

In recent years, several providers have attempted to make their businesses a “one-stop shop” for home care services. Others have stayed in their respective lanes.

“There’s other ways besides having it all under your control and all under your umbrella,” Dombi said. “You can engage in virtual collaboration. The reality is ,you should be thinking about these aspects and making a conscious decision rather than having decisions being made around you, and then affecting you without your input and influence.”

Regardless of the path a provider selects, it’s important to make this decision early, guided by well-informed decision-makers, and to adhere to the chosen plan with diligence, Dombi added.

Potential thunderstorms

In the last 18 months, the big are getting bigger in home health care.

Despite that continued consolidation, there’s room for opportunity that comes with these new challenges.

“New opportunities continue to surface throughout the marketplace to those who want to embrace change,” Dombi said. “That includes retail health care. Physicians are getting involved in health care services at home by sending their nurses to patients’ homes rather than the home care companies. These are things that you should have your eyes open to.”

On the workforce side, retention should be a primary focus for all providers, Dombi said.

“When we look at dealing with your workforce issues, retention should be a primary strategy,” he said. “When you lose someone, it is a very disruptive matter. It’s costly, time consuming and can affect patients.”

The post NAHC President Dombi: Providers Need To Keep Their Eyes Open To Innovation appeared first on Home Health Care News.

The plan came with what Dombi described as an “aggressive timeline,” hoping the merger would be done by 2024.

“It’s an aggressive timeline even if we’ve been moving very, very deliberately,” Dombi told a group of reporters at NAHC’s annual conference. “We have yet to exchange the data and have it analyzed on the due diligence side of things. Obviously, fiduciary obligations tell us we’ve got to do a deep dive here, and no one’s not cooperating in this — it’s just going to take some time.”

From now until the potential merger, NAHC and NHPCO will be operating business as usual and will work as two separate entities. If the merger is finalized, the two will then integrate their businesses together and will work on a combined strategy that will be put in place for 2025.

During a keynote speech at NAHC’s annual conference, Dombi said the goal of the merger is to create “one single organization integrated from top to bottom, with the recognition that health care at home is a broad breadth of services that we’re there to represent.”

Following the announcement, Dombi told reporters that he and NAHC had received some pushback about the merger, particularly from one sector.

“Most of the negative comments, for example, have included, ‘Will hospice get lost in this mix?’” Dombi said. “Those are coming from people who don’t really understand that hospice is not a new area for us. There have been decades of very successful work on the advocacy side for hospice. The education side of [the merger] should take care of some of the criticisms and some of the questions that have been raised.”

As far as Dombi’s future with the association, he is expected to stay on board through 2024 to see through the potential merger. After that is still up in air.

“The intention is that I’m here through 2024,” Dombi said. “With an expectation that, assuming we come together somewhere in the middle of the year, then I’m there in the role of the new organization as the president emeritus. Something like that.”

The latest

During a virtual town hall meeting earlier this month, NAHC’s board chair Ken Albert said the next few months will consist of organizational structure meetings with a steering committee and a CEO search for the new association.

“We will absolutely identify the economic and financial framework that we need to work with in order to be able to balance association management with highly qualified staff to produce a value-based product for our members,” Albert said. “I think that also includes hopefully being able to take some reserves on an annual basis to invest in a portfolio for rainy day investment. I think that’s prudent under these circumstances. It reminds me that we need to continue to reassure our members that business prudence and due diligence is being employed all along the way as we’re designing what this new organization will look like.”

The definitive agreement should be signed and finalized by the end of the year, Albert said.

“Our conversations are always focused around what members need,” Albert said. “Building something that is with an eye towards the future and taking the best from both organizations as we move forward.”

The post NAHC, NHPCO Merger Remains On ‘Aggressive Timeline’ appeared first on Home Health Care News.