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New Bills, CMS and Direct Contracting Changes Affect Hospice Industry

HCHB Hospice - June

To keep you informed on news, innovation, education and advocacy issues around home-based care, we’ve pulled together these important headlines.

Direct CARE Opportunity Act

A bill has been introduced to the U.S. House of Representatives that is designed to grant federal funds to home-based providers for recruitment, retention and advancement of direct care workers. The Direct CARE Opportunity Act works to address the need ​“for a prepared, well-trained and empowered direct care workforce now and for the future.” Read the full article here.

Better Care Better Jobs Act

After the removal of HCBS support from the infrastructure package, a group of senators announced a new bill to give states more money to expand home-based care programs and make some temporary policies permanent. Read the rest of the article here.

Infrastructure Legislation

A new $1.2 trillion bi-partisan proposal from the senate includes infrastructure updates such as roads, bridges, airports and waterways, but removes $400 billion in anticipated funds from HCBS. Senator Elizabeth Warren expressed her dismay over these changes. Read the rest of the article here.

The U.S. Senate continued the infrastructure conversation with a special committee on aging hearing. During the hearing, caregivers and leaders providing HCBS services spoke. There is evidence of strong bipartisan support for aging in place, but disagreement on whether HCBS services should count as infrastructure and be given further monetary support. Read the full article here.

Partnerships

From transportation agreements to employee engagement and business development tools, the variety of important partnerships in home-based care is impressive. Leaders in home care came together to share their opinions on which partnerships are the most important in 2021. Read the full article here.

Medicare Advantage

Medicare advantage plans have seen impressive growth over the past couple of years. Today, more than 26 million beneficiaries are enrolled in MA, which is close to 42% of the total Medicare program. The Congressional Budget Office, believes that number will rise to close to 40 million by 2023. Read the rest of the article here.

Vaccination Reimbursement

CMS has raised the reimbursement rate for in home vaccinations to encourage more Medicare vaccination deployment for vulnerable homebound populations. The reimbursement rate for in home vaccinations is now $75 per dose. CMS has also provided a new billing code to help track the number of in-home vaccinations moving forward. Read the full article here.

Provider Relief Funds

$10 billion of the remaining CARES Act funds will be dispersed soon and official reporting for how previously dispersed funds have been spent will begin soon. The PRF reporting portal will open for providers on July 1st and the initial reporting period will run through September 30, 2021. Read the rest of the article here.

PPP Loans

If your organization is entertaining the idea of selling or acquiring another agency, take a careful look at PPP loan status. There are rules for negotiating on a deal when PPP loans are involved. Make sure you understand your agency’s status. Read the full article here.

MedPAC

MedPAC recommended that CMMI consider reducing the number of overlapping programs/​models and focus on clarity and harmony to avoid unintended consequences. Read the rest of the article here.

THIS MONTH IN HOSPICE

CMS

The U.S. Centers for Medicare & Medicaid Services have added new criteria and enforcement remedies that will affect hospice agencies including the establishment of a Special Focus Program (SFP). The SPF will have the power to impose fines, suspend reimbursement, appoint temporary management or revoke Medicare certifications. A hospice quality hotline for reporting concerns has also been proposed. Read the rest of the article here.

Palliative Care

Medicare’s Primary Care First initiative (direct contracting program) and the Value-based Insurance Design Model (Medicare Advantage hospice carve-in) are the first value-based payment models available for hospice participation. Hospices are eager to work palliative into their value-based care strategies. Read the full article here.

VBID

The Medicare Advantage hospice carve in started small this year, in part because of the pandemic, but it is expected to grow in the next couple of years. VBID is one of the best growth opportunities that hospice agencies have to leverage palliative services, as well as traditional end of life care. Read the rest of the article here.

Mental Health

Hospice providers are mobilizing to improve end-of-life care for those with mental illness. Research has shown disparities in care for those with SPMI (severe and persistent mental illnesses). People with SPMI make up roughly 6% of the U.S. population. Education and training for providers is an important first step to take to serve this group. Read the full article here.

Florida Hospice Expansion

The Florida Agency for Health Care Administration has expanded hospice program in seven counties by increasing certificates of need. Florida has the fourth highest rate of hospice utilization in the country. Read the rest of the article here.

HOSPICE CUSTOMERS IN THE NEWS

Workforce Recruitment Innovation

Three of HCHB’s customers were highlighted in a Hospice News article surrounding workforce innovation. The article cited the efforts Amedisys, LHC Group and Silverstone Hospice are making to differentiate themselves from the competition and hire amid extreme workforce shortages. Read the full article here.

Compassus

Compassus CMO Kurt Merkelz, M.D. took a moment to speak with Hospice News about the potential short and long term impacts of telehealth. The lack of telehealth billing codes or quality reporting metrics are proving a challenge for hospice agencies. Read the rest of the article here.

Kurt Merkelz, M.D. took the time to author an article from the hospice provider perspective for Medpage Today. The article, entitled ​“Don’t Neglect Quality Care in Patients’ Final Days” covers the importance of continuing tele-health beyond the pandemic and examined deficiencies in the hospice proposed rule. Read the full article here.

Agape Care

Agape Care has entered into an agreement with South Carolina Department of Health and Environmental control (DHEC) to use their inpatient facilities as medical needs shelters during weather emergencies and disasters. The company will house evacuated residents who need medical aid, but do not require hospitalization. Read the full article here.

Agape Care acquired Georgia-based Serenity Care to continue growth in this state. Read the rest of the article here.

Mission Healthcare and Silverado Hospice

Two Homecare Homebase customers are joining forces. Mission Healthcare announced that the company will acquire Silverado Hospice, which will increase its reach to include the state of Utah. Read the rest of the article here.

The Pennant Group, Inc.

First Call Hospice based in Sacramento, California is the latest hospice acquisition for The Pennant Group, Inc. The acquisition will help Pennant expand its presence in Northern California. In the first quarter of 2021, the company saw a 23.4% rise in census over Q1 of 2020. Read the full article here.

St. Croix Hospice

St. Croix Hospice has opened a de novo location in Hudson, Wisconsin. This is the company’s fourth new location in 2021. The organization has ambitious plans for growth, focusing on the Midwestern region of the United States. Read the rest of the article here.

RESOURCE ARTICLES

Strength in Numbers: Home Care Executives Reveal 2021’s Most Important Partnerships” By Joyce Famakinwa, Published by Home Health Care News on June 1, 2021

Home Care Providers Likely to See More Medicare Advantage Opportunities as Enrollment Grows” By Joyce Famakinwa, Published by Home Health Care News on June 8, 2021

To Better Protect Homebound Seniors, CMS Boosts Medicare Rates for At-Home COVID-19 Vaccinations” By Robert Holly, Published by Home Health Care News on June 9, 2021

​‘Care Is Infrastructure’: Sen. Warren Calls for HCBS Support Following New Bipartisan Proposal” By Robert Holly, Published by Home Health Care News on June 13, 2021

HHS Issues New Reporting Requirements, Deadlines for Provider Relief Fund Recipients” By Robert Holly, Published by Home Health Care News on June 11, 2021

PPP Forgiveness Continues to Slow Down the Home Health M&A Process” By Andrew Donlan, Published by Home Health Care News on June 14, 2021

MedPAC: CMMI Should Consider a ​‘Smaller, More Harmonized’ Portfolio of Alternative Payment Models” By Robert Holly, Published by Home Health Care News on June 15, 2021

Senators, Advocates Tout ​‘Once-in-a-Generation Opportunity’ for Funding HCBS” By Robert Holly, Published by Home Health Care News on June 17, 2021

Congress Mulls Bill to Bulk Up Direct Care Hospice, Home Health Workforce” By Holly Vossel, Published by Hospice News on June 25, 2021

​‘Better Care Better Jobs Act’ Seeks Permanent FMAP Bump, Higher Wages for HCBS Workers” By Robert Holly, Published by Home Health Care News on June 24, 2021

Compassus CMO Merkelz: Better Payment System Needed for Hospice Telehealth” By Jim Parker, Published by Hospice News on June 2, 2021

South Carolina Agencies Partner with Hospice Providers on Disaster Response” By Robert Holly, Published by Home Health Care News on June 7, 2021

Value-Based Models Could Promote Palliative Care Integration” By Holly Vossel, Published by Hospice News on June 11, 2021

Quality Data, Education Key to Hospice-Payer Relationships in VBID” By Holly Vossel, Published by Hospice News on June 11, 2021

Mission Healthcare Acquires Silverado Hospice” By Jim Parker, Published by Hospice News on June 15, 2021

Pennant Group Acquires First Call Hospice” By Jim Parker, Published by Hospice News on June 17, 2021

Hospices Mobilize to Better Serve Mentally Ill Patients” By Holly Vossel, Published by Hospice News on June 17, 2021

St. Croix Hospice Expands with New Wisconsin Location” By Jim Parker, Published by Hospice News on June 16, 2021

Hospices Innovate to Build Workforce Amid Staff Shortages” By Jim Parker, Published by Hospice News on June 21, 2021

Don’t Neglect Quality Care in Patients’ Final Days” By Kurt Merkelz, M.D., Published by Medpage Today on June 6, 2021

Florida Paves Way for Hospice Expansion, Doubles 2021 Certificates of Need” By Jim Parker, Published by Hospice News on June 24, 2021

Hospices Gear Up for Overhauled CMS Survey Process” By Jim Parker, Published by Hospice News on June 29, 2021

Agape Care Acquires Georgia Hospice Provider Serenity” By Jim Parker, Published by Hospice News on June 29, 2021