Care at Home News Review
Read on for the Alliance’s regular round-up of important home care, home health, hospice, and palliative care stories from around the country.
Providers ‘disappointed’ with CMS’ release of initial cohort of hospices in Special Focus Program
The National Alliance for Care at Home expressed dismay that, despite criticism, the Centers for Medicare & Medicaid Services released the names of initial hospices selected for participation in the Special Focus Program, which aims to identify poor-performing providers.
“The [Alliance’s] major reaction is one of disappointment,” Steve Landers, MD, chief executive officer of the Alliance, told McKnight’s Home Care Daily Pulse Monday in an interview. “CMS has marched forward using flawed methods that aren’t consistent with the original intent of the law that created the Special Focus Program.”
Three-month extension ‘sets the stage’ for permanent hospital-at-home, telehealth programs, Alliance says
With Congress’ late December move to extend hospital-at-home and telehealth flexibilities until the end of March, these critical home care programs now are likely to become permanent fixtures in Medicare, according to the National Alliance for Care at Home.
“While we absolutely would prefer that this have been done on a longer-term basis, we’re optimistic that … we’re in a good position,” Steven Landers, MD, chief executive officer of the Alliance, told McKnight’s Home Care Daily Pulse Monday in an interview. “The fact that those are included, albeit in a short renewal, sets the stage, we believe, for a longer-term extension.”
In pivotal case, federal court rules in favor of HCBS for people with disabilities
In what senior care stakeholders have described as a potentially “game-changing” decision, the US District Court for the District of Columbia ruled this week that state and local governments must do more to help people with disabilities access home- and community-based services.
The class-action case, Brown, et al v. District of Columbia, found that Washington, DC, failed to inform Medicaid nursing facility residents that they could leave their facilities and instead receive home health services in their communities. Washington, DC, also failed to connect these patients with housing options and community-based services to ease their transitions home.
Jimmy Carter dies at 100 after nearly 2 years in hospice care
Former President Jimmy Carter died on Sunday after spending nearly two years in hospice. For many providers, Carter’s experiences in hospice and advocacy for hospice as president made him a champion of the Medicare benefit.
“Consistent with his life of service and leadership, President Carter made the courageous decision in February 2023 to publicly share his choice for hospice care,” the National Alliance for Care at Home said Sunday in a statement. “Since then, he received hospice services from the comfort of his home surrounded by loved ones. By making his choice public, President Carter … led by example, showing Americans how to embrace a stage of life that many don’t want to think or talk about. He showed the nation how hospice helps patients live full lives at the end of life.”
Rural caregivers unfamiliar with local hospice offerings, Alliance survey finds
Although most people are aware of the benefits provided by hospices, many caregivers of seniors in rural areas do not know the names of any hospice providers in their communities, according to a new survey report by the National Alliance for Care at Home and Transcend Strategy Group.
The survey, which sampled more than 400 people in rural and small-town communities, found that approximately 40% of respondents were unable to name a single hospice provider serving their community. Older individuals were less likely to be familiar with their local hospice options, whereas younger respondents had the greatest degree of familiarity with hospices in their communities.
Hospital-at-home achieved cost savings among all top diagnosis groups, CMS reports
Since its launch roughly four years ago, the Acute Hospital Care at Home (AHCAH) waiver initiative achieved modest cost savings compared with traditional brick-and-mortar hospital care. At the same time, it generated mostly positive feedback from patients and clinicians, according to results of a Centers for Medicare & Medicaid Services study.
CMS, which shared results of the study on Tuesday, examined Medicare costs and care quality of hospital-at-home services to treat patients of 13 different diagnosis groups, including respiratory circulatory, renal and infectious diseases.
CMS Lays Out Action Item Timeline For Transition To All-Payer OASIS Data Collection
The U.S. Centers for Medicare & Medicaid Services (CMS) has laid out an action items timeline for the transition to all-payer Outcome and Assessment Information Set (OASIS) data collection and submission. The all-payer OASIS data requirement is set to begin in 2027.
Broadly, home health providers will be required to collect and submit OASIS data for more patients. This means non-Medicare and non-Medicaid payer sources, as well as individuals who self-pay.
Home health spending grew 10.8 percent last year, continuing expansion trend: CMS
Home healthcare was one of the fastest-growing health spending categories last year. This tracks with historical trends measured since 1980, according to data from the Centers for Medicare & Medicaid Services.
CMS, in collaboration with HealthAffairs, released its National Health Expenditures in 2023 report on Wednesday. The report found that national health spending on home healthcare was $147.8 billion in 2023. This represents a 10.8% increase over the year prior. This spending compares with other categories such as hospital care ($1.5 trillion, a 10.4% increase year-over-year), nursing care facilities and continuing care retirement communities ($211.3 billion, a 9.5% increase), prescription drugs ($449.7 billion, an 11.4% increase) and durable medical equipment ($72.8 billion, a 6.2% increase). Spending growth was largely driven by increasing utilization of healthcare services, rather than price increases, the report noted.
Home health visits, admissions fall nationwide, industry report finds
Medicare beneficiaries face declining access to home health services, and those who live in rural areas have it the worst, according to a report by market intelligence firm Trella Health.
Approximately 94% of United States counties experienced either a decrease or no change in the number of home health agencies treating 10 or more patients in 2024, the report said. The same year, 83% of counties saw a decrease in the number of home health admissions and 87% saw a decrease in the number of home health visits provided to Medicare fee-for-service beneficiaries. These decreases suggest a broader trend: Between 2017 and 2023, home health visits per patient day dropped more than 17%.
Top Hospice Trends to Watch in 2025
Hospice leaders will need to keep their eyes on five key trends in the new year when it comes to compliance, business operations and finance.
Coupled with these trends is rising utilization. Hospice utilization reached 51.7% among Medicare decedents in 2023, up more than two percentage points from the prior year, according to recent data from the Medicare Payment Advisory Commission (MedPAC). This is the highest rate since 2019. MedPAC observed increases in utilization across the board, even when stratified into subgroups by age, sex, race and rural or urban location.
The Top 10 Home Health Care News Stories Of 2024
Major deals hit snags. Home health cuts continued. Regulatory noise came in from all sides, in Medicare and in Medicaid.
All of those realities made their way into Home Health Care News’ most popular stories for the year.
In order to summarize the 2024 that providers had, HHCN is revisiting 10 of its most widely read stories.
New Year’s resolutions to manage workforce-related legal exposure in 2025
As home-based care providers put their heads down and sprint into 2025, many will overlook workforce-related legal risks on the horizon that bring with them significant potential exposure, particularly with an uncertain regulatory and political environment. But now is the time when forward-thinking providers tackle these risks to mitigate their potential exposure and position themselves for success in 2025.
The following are five of the top employment-related legal risks facing providers in the home care, home healthcare and hospice industries — with New Year’s resolutions for providers seeking to avoid significant exposure down the road:
Oncologists: Palliative Care Plays ‘Critical Role’ in Improving Quality, Health Equity
Interdisciplinary palliative care delivery can help to improve quality and health disparities among underserved cancer patient populations, according to oncology specialists.
Cancer patients across diverse cultural, ethnic and racial backgrounds often lack access to goal-concordant care that sufficiently addresses their physical, emotional and spiritual needs, according to Nadine Barrett, president of the Association of Cancer Care Centers (ACCC).
These disparities leave opportunities for greater collaborative partnerships between palliative care providers and oncologists, Barrett said in a recent ACCC Open Forum discussion. Barrett is also the associate director of community outreach and engagement at Atrium Health Wake Forest Baptist’s Office of Cancer Health Equity.
CMS to shutter MA VBID program, cites ‘substantial and unmitigable costs’
The Centers for Medicare & Medicaid Services disclosed that it will be sunsetting the Medicare Advantage Value-Based Insurance Design program next year. The agency said that uncontrollable cost growth contributed to the decision to end the program.
MA VBID allowed participating MA organizations to tailor enrollees’ benefits based on their chronic health conditions, socioeconomic status and geographic location in an effort to drive better health outcomes. Participating MAOs could also use incentives to promote Medicare Part D benefits or pay for hospice care for members.
Hospice M&A Market to ‘Return to Sanity’ in 2025
The hospice mergers and acquisitions market has seen a host of changes in recent years, with buyers and sellers examining a range of risks and opportunities in the field this year.
The industry saw a flurry of M&A activity in 2019 and 2020, with record high valuations and deal volume. Subsequent years saw cooling periods that left many operators wondering what’s next in store as 2025 unfolds.
The previous “buy, buy, buy” mentality among hospice investors has morphed into a more disciplined strategic approach, according to New Day Healthcare LLC CEO G. Scott Herman. Certain lessons learned are driving future hospice investment decisions, particularly those around valuations and keys to sustainable growth, Herman said during a recent Hospice News Elevate podcast.
Hospice clinicians hold doubts about use of antipsychotics, study finds
Although antipsychotic medications are commonly used in hospice settings, some end-of-life clinicians are concerned about their effectiveness compared with other treatment options, according to a new study published in the Journal of the American Geriatrics Society.
The researchers found that hospice clinicians were primarily concerned about the physical side effects of antipsychotics, particularly extrapyramidal symptoms such as muscle stiffness, anxiety, movement dysfunction or drowsiness. Meanwhile, patients’ caregivers and family members were more likely to be concerned that antipsychotics could cause harm to their loved one’s health or personality.
MA Special Needs Beneficiaries More Likely to Receive Lower Quality Hospice Care
Medicare Advantage special needs plan (SNP) beneficiaries were more likely to use lower-quality hospices than those enrolled in fee-for-service Medicare.
Researchers from the Perelman School of Medicine at University of Pennsylvania in Philadelphia examined Medicare enrollment and claims data for 4.2 million decedents and 2.2 million hospice enrollees from Jan 1, 2018 to Dec. 31, 2019. Among other findings, results indicated that MA SNP beneficiaries were more likely to receive care from hospices with lower Hospice Quality Reporting Program (HQRP) scores.
