Message From Lisa Remington
May/June 2023 Issue
FREE CONTENT In the May/June issue of The Remington Report, we provide a special industry report for home-based care providers to identify the gaps in care delivery.
Get to Know the New Providers in Care-at-Home Delivery
May/June 2023 Issue
SUBSCRIBER CONTENT Disruptors or non-traditional providers are quickly accelerating their footprint into the care-at-home market. These providers are addressing the pain points and healthcare gaps that traditional-for-service providers have failed to correct for many years.
Lack of Patient Discharge Instructions Disrupt Care Transitions
May/June 2023 Issue
SUBSCRIBER CONTENT Learn the five key areas that home-based care organizations could assist in discharge planning.
Court Upholds Medicare Contractor’s Decision to Deny Claims Based on Untimely Appeal
May/June 2023 Issue
SUBSCRIBER CONTENT Learn the results of a homecare agency’s audit and appeals case.
The Patient’s Perspective on Their Care Transition Process
May/June 2023 Issue
SUBSCRIBER CONTENT Learn the perspectives of patients regarding their care transition experience after discharge.
ED Patients: Partnering with Home-Based Care to Fill Gaps in Care
May/June 2023 Issue
SUBSCRIBER CONTENT The emergency department (ED) is the hospital's front door, providing over 70% of all hospital admissions. How can home-based care providers partner with EDs?
Potential Changes to the Home-Based Care Industry
May/June 2023 Issue
SUBSCRIBER CONTENT The Expanding Care in the Home Act: By moving an array of services for Medicare beneficiaries from hospital to home, lawmakers hope they can save money while allowing older Americans to receive care in their homes. Get an understanding of a new proposed bill.
8 Factors Leading to Clinician Satisfaction and Retention
May/June 2023 Issue
FREE CONTENT In this special report, we provide guidance to help your organization improve the clinician experience and gather data to easily track satisfaction and achieve a more engaged workforce.
Message From Lisa Remington
March/April 2023 Issue
FREE CONTENT In the March/April issue of The Remington Report, we report on the trends, transformation, and opportunities impacting ACOs.
16 Key ACO Trends to Know in 2023
March/April 2023 Issue
SUBSCRIBER CONTENT The importance of key ACO trends is to better understand the plan to decrease fee-for-service and increase value-based payments. Growth through three initiatives will be the foundation to reach CMS’s goal of 100% of Medicare into an accountable care program.
What Motivates ACOs to Make Home Visits?
March/April 2023 Issue
SUBSCRIBER CONTENT Learn the seven reasons why ACOs use home care and what’s behind the motivation.
Preferred-Provider Arrangements Between Home Health, Hospice and Private Duty Agencies, and Assisted Living Facilities and Retirement Communities
March/April 2023 Issue
SUBSCRIBER CONTENT Preferred-provider agreements are an important strategy for increasing referral relationships. This article provides a greater understanding of the legal aspects.
ACO Reach Model Expands Home-Based Care Primer
March/April 2023 Issue
SUBSCRIBER CONTENT This article summarizes the major provisions of the new ACO Reach Model and the expanded role of home-based care providers.
Senior Care Profiles
March/April 2023 Issue
SUBSCRIBER CONTENT The profile of seniors is changing according to the Administration on Aging. Get the latest information.
Why Collaboration Across the Care Continuum Improves ACO Patient Experience
March/April 2023 Issue
SUBSCRIBER CONTENT A study out of the Ohio State University Fisher College of Business explores factors that can help ACOs deliver more efficient and effective health care, by how much and the costs associated with these improvements.
HIPAA Violations to Avoid
March/April 2023 Issue
SUBSCRIBER CONTENT Compliance with HIPAA can be complex. Examples of violations, or “HIPAA stories,” may make requirements more understandable. We share some of those stories.
Maryland Total Cost of Care Model
The model aims to improve the overall health of Marylanders, reduce avoidable hospital readmissions and emergency department visits, and improve the patient experience in health care settings.
Legal: Court Decision Extends Responsibilities of Board of Directors to Individual Corporate Officers
A 1995 court decision involving Caremark established that members of boards of directors likely have liability for non-compliance with fraud and abuse prohibitions. A recent Court decision likely extends liability to individual corporate officers.
Performance of Efficient Home Health Agencies in 2020
To identify efficient HHAs, CMS examined cost efficiency and quality at freestanding HHAs to identify a cohort that demonstrated better performance on these metrics relative to peers.
The Top 5 Conditions Most Used for Hospice
The top five conditions most used for hospice.
Medicare Hospice Spending by Length of Stay
Nearly 60 percent of Medicare hospice spending in 2020 was for patients with stays exceeding 180 days.
Hospice Quick Fact Market Overview from Latest Data
Hospice quick fact market overview from the latest data.
Legal: HIPAA Violations To Avoid
Compliance with HIPAA can be complex. Examples of violations, or “HIPAA stories,” may make requirements more understandable. Here are some of those stories.
5 Trends and Policies Impacting Social Determinants and Outcomes
The focus on social determinants of health in 2023 is uniting payers and providers to increase their efforts to find solutions and improve outcomes. Driven by policy and payments, change is coming.
Message From Lisa Remington
January/February 2023 Issue
FREE CONTENT In the January/February issue of The Remington Report, we unlock the big wave of changes ahead for home-based care in 2023.
30-Day Readmission Trends to Improve Outcomes
January/February 2023 Issue
SUBSCRIBER CONTENT Key studies and data can help providers reduce readmissions, improve outcomes, and increase partnerships.
5 Changes to Social Determinants of Health Quality Measures Across the Continuum 2023
January/February 2023 Issue
SUBSCRIBER CONTENT New social determinants of health (SDOH) quality measures will be required by hospitals, health plans, and multi-payer federal and state programs. We provide details on how each healthcare sector will be incorporating SDOH quality measures.
Trends Driving Home-Based Care’s Contracting Options with Medicare Advantage Plans
January/February 2023 Issue
SUBSCRIBER CONTENT Home care is big business for payers. No better industry is more aligned with payer goals than home-based care. We address six strategies to evaluate contracting with Medicare Advantage plans.
2023 CMS Adding Physician Relationships to Home Care Providers on Medicare’s Care Compare Website
January/February 2023 Issue
SUBSCRIBER CONTENT Medicare’s Care Compare website is adding physician and clinician affiliations to home-based care organizations. The new information is meant to provide additional information to support patients and caregivers as they make healthcare decisions.
5 Ways Health Equity is Advancing in Medicare Models
January/February 2023 Issue
SUBSCRIBER CONTENT In this article, we explore the models of care advancing health equity and the closer connection to value-based care.
Home Care and Hospice Payment Recommendations for 2024
January/February 2023 Issue
SUBSCRIBER CONTENT The Medicare Payment Advisory Commission submitted its official payment recommendations to Congress for March FY2024. Recommended cuts include home healthcare and hospice.
Electronic Visit Verification Systems Required January 1, 2023
January/February 2023 Issue
SUBSCRIBER CONTENT Medicaid-funded personal care services and home healthcare services will need to be fully compliant with their state’s electronic visit verification systems by January 1, 2023. We review the oversight and details.
9 Key Trends: How CMS is Aligning Value-Based Arrangements Across Traditional Medicare Programs
January/February 2023 Issue
SUBSCRIBER CONTENT CMS has indicated that the agency intends for anyone with Medicare coverage to be under a value-based payment arrangement by 2030. Learn which fee-for-service programs are advancing value-based care.
Do You Know Which Principal Diagnosis Has the Highest Rate of 30-Day Readmissions?
As a home-based care provider, all referral partners have the same goal – how to reduce readmissions and the cost. It’s important to continue to hone in on data that can help your organization better understand your role in preventing readmissions and reducing the cost of care.
Clinical Service Lines that Reduce the Cost of the Top 5 Medical Conditions
New information will help your organization better align clinical services to reduce the cost of the highest medical conditions and their expenditures. The data can be used in conversations with various payer sources to align your organization’s services to reduce the cost of care and readmissions.
Message From Lisa Remington
November-December 2022 Issue
FREE CONTENT In the November/December issue of The Remington Report, we tackle topics impacting team-based care, care transitions, case studies, and workforce improvement.
5 Ways High-Functioning Team-Based Care Reduces Clinician Burnout
November-December 2022 Issue
SUBSCRIBER CONTENT Fostering effective team-based care improves both the patient’s and the team’s experience of care delivery. In this article, we discuss the two different approaches to team-based care, the five core principles, and how to reduce clinician burnout.
How Proactive Team-Based Care Engagement Improves Care Transitions
November-December 2022 Issue
SUBSCRIBER CONTENT Care transitions promote improved outcomes when discharge planning, home-based care, physicians, and hospitalists engage on the first day of an inpatient admission.
Which Types of ACOs Use Home Visits the Most and Why?
November-December 2022 Issue
SUBSCRIBER CONTENT Home-based organizations eager to have partnerships with ACOs will learn in our discussion why certain ACOs engage in greater home visits and care transitions to manage complex patients. No two ACOs are alike. Get insights into the characteristics of ACOs and their decision points. We follow up with three key leadership discussion questions.
Care Transitions Intervention Model to Manage Social Determinants of Health
November-December 2022 Issue
SUBSCRIBER CONTENT The focus on social determinants of health is a hot topic in healthcare. Multidisciplinary teams and a care transition model in the case study resulted in reduced readmissions and improved outcomes. The model is scalable and a win-win for healthcare and the patient.
36 Ways Your Investment in Technology Can Produce a Positive ROI Across Your Organization
November-December 2022 Issue
FREE CONTENT In this special report, we provide 36 ways your investment in technology can produce a positive ROI across your organization. We identify the right technologies to get a positive return on your investment.
Pre-Hospice Home-Based Transition Program
November-December 2022 Issue
SUBSCRIBER CONTENT Sharp HealthCare pre-hospice program called Transitions, is designed to give elderly patients the care they want at home and keep them out of the hospital.
Improving Real-Time Communications with Care Teams and Patients
November-December 2022 Issue
FREE CONTENT In our extensive resource of special reports, you’ll find actionable solutions to improving care transitions, real-time communications with team members, and what patients want for better communications. These complimentary resources offer solutions to workforce shortages, clinician burnout, and advancing solutions in home-based care.
7 Things Changing in Healthcare 2023 You Should Know About
November-December 2022 Issue
SUBSCRIBER CONTENT Seven areas of healthcare are changing in 2023 related to quality measures, bundled payments, the hospice benefit, and the expanded HHVBP model. For each, we provide details and resources to keep you in the know.
Legal: Workforce Hiring and the Crackdown on “No-Poach” Agreements
“Poaching agreements” may produce artificial suppression of employees’ compensation and may violate the federal Sherman Act.
Legal: 6 Fraud and Abuse Issues to Avoid When Marketing to Referral Sources
The Office of Inspector General has stated that there are two major types of fraud and abuse compliance that must be addressed through ongoing evaluation processes.
Legal: Practitioners Liable for Harm to Patients and Fraudulent Conduct Despite Physicians’ Orders
Practitioners owe a duty of care in the diagnosis and treatment of patients even though they are working under the supervision of licensed physicians.
2023 Providers are Responsible for Social Determinants of Health Quality Measures
Research shows that social determinants can be more important than health care or lifestyle choices in influencing health. Numerous studies suggest that SDOH account for between 30-55% of health outcomes.
To the Point
September/October 2022 Issue
FREE CONTENT How are the changing financial, economic, and market conditions impacting your decisions about your workforce? A major change is coming that will determine your future staffing needs.
Workforce Analysis: What are the Key Factors That Would Motivate Nurses to Stay in the Profession?
September/October 2022 Issue
SUBSCRIBER CONTENT The crisis level of the nursing shortage has no easy fix. A national survey provides insights into what are the most important benefits for nurses, how salaries compare nationwide, and what are the most crucial factors for job satisfaction.
Workforce: How Will Medicare Fee-For-Service Trends Change the Way You Think About Future Staffing Needs?
September/October 2022 Issue
SUBSCRIBER CONTENT With all the evolving changes occurring in healthcare, you may have missed CMS’s initiatives aligning value-based arrangements across traditional Medicare programs. We discuss the eight trends to help your organization think about the impact on your labor force and referral partners.
11 Strategic Actions to Improve Care Team Productivity
September/October 2022 Issue
SPECIAL REPORT In this special report, we provide 11 strategic actions to improve your care team's productivity both internally and externally. Get insights into advancing clinical communications with your referral partners, ways your care team always has real-time patient status, and how to improve the referral process. Don't miss the eight additional resources to dig even deeper into this topic.
Workforce: How is the Role of Nurse Practitioners Changing?
September/October 2022 Issue
SUBSCRIBER CONTENT The role of the nurse practitioner continues to grow with more than 355,000 NPs nationwide and growth projections of 45% by 2030. We provide important state-by-state analysis and annual salaries.
4 Care Transition Challenges and How to Solve Them
September/October 2022 Issue
SPECIAL REPORT/FREE CONTENT In this special report, learn about the challenges and solutions to effective care transitions, competitive tools, and shared peer actions.
Workforce Analysis: What are the Best States for Nurses to Work In? The Worst States?
September/October 2022 Issue
SUBSCRIBER CONTENT Getting to know the nursing workforce by state helps to know states with the most job openings, salaries, and the best and worst states to work. We give you the intel.
Analysis: Seniors Usage of Technology and Telehealth Growing
September/October 2022 Issue
SUBSCRIBER CONTENT The gap between the younger generation and the senior population is narrowing when it comes to smart phones, tablets, internet users, YouTube, and telehealth. A recent study provides valuable insight for healthcare providers adopting technology in the home.
Workforce: Rural Communities Get Investment to Improve Health Care Workforce and Access
September/October 2022 Issue
SUBSCRIBER CONTENT $60 million in investments will expand and improve the rural community workforce. We provide details and resources for each.
Staffing Strategies: Efficient Ways to Leverage Scheduling for Improved Staffing Utilization and Increased Continuity of Care
September/October 2022 Issue
SPECIAL REPORT What are the four questions leadership should explore to optimize scheduling with continuity of care and staff utilization? In this special report, we answer these four questions and give you solutions to help provide better care to more patients, while making the most of your staff’s time. This effort starts with their scheduling process.
Workforce: Job Outlook for Home Health and Personal Care Aides
September/October 2022 Issue
SUBSCRIBER CONTENT The job outlook for home health and personal care aides is growing much faster than all occupations. Our analysis breaks it down by state and wages.
The Number of Home Health Agencies Decline
According to the most recent MedPAC report, the number of home health agencies has been declining since 2013 after several years of substantial growth.
What are the Highest Chronic Care Conditions in Medicare, Medicare Advantage Plans, and Special Needs Plans?
Payers are developing care models specific to the level of need. There is not a one-size-fits-all care-management strategy. Payers tend to categorize medical conditions by risk.
Legal: Kickbacks to Discharge Planners and Case Managers – A Recent Case
Case managers/discharge planners continue to come under fire from fraud enforcers for violations of the federal anti-kickback statute.
To the Point
July/August 2022 Issue
FREE CONTENT Payers are gaining a foothold in the care-at-home market. Five critical trends support the rapid advancement. The challenges and opportunities are discussed in this issue of The Remington Report.
Trend #1: Payers Are Accelerating Into the Home-Based Care Market
July/August 2022 Issue
SUBSCRIBER CONTENT How should your organization be responding to payers expanding their position in home-based care? What key trends support this advancement? What are key strategies to partner and align with payers? In this article, we cover the key market changes, the disruption, and growth opportunities for home-based care organizations.
Trend #2: Payers Expanding Home-Based Care Models Nationally
July/August 2022 Issue
SUBSCRIBER CONTENT Payers are deepening their care delivery models focused on the home. In the past, we may have thought of payers in traditional roles as a medical-cost manager. Today, they are acquiring home-based care organizations to control readmissions, cost, and outcomes.
Trend #3: Highest Chronic Care Conditions in Medicare, Medicare Advantage Plans, And Special Needs Plans
July/August 2022 Issue
SUBSCRIBER CONTENT Different payers such as Medicare, Medicare Advantage, and Special Needs Plans are focusing on the highest chronic care conditions to reduce the cost of care. In this article, is the data by payer and a discussion about how organizations can support a better aligned financial and quality partnerships.
Trend #4: Growth in Medicare Advantage Plans 2022 Signals Future in Managed Care Contracting
July/August 2022 Issue
SUBSCRIBER CONTENT Medicare Advantage enrollment is growing at a fast pace. The number of plans is expanding geographically, and payers will continue to invest in the Medicare Advantage market. In this article, we dig deep into the growth of Medicare Advantage by enrollment, states, and the future. The market signal is strong to put Medicare Advantage contracting as a high priority.
Trend #5: Payer and Home-Based Provider Partnering to Reduce the Cost of Care
July/August 2022 Issue
SUBSCRIBER CONTENT Important to all payers is the value your organization brings to reducing the cost of care. Available data can gear-up your partnership value quickly. In this article, we sliced and diced data to provide an overall macro/micro picture of how to reduce the cost of care.
Strategic Priority: Facts Driving Why Family Caregivers Choose One Care-at-Home Organization Over the Other
July/August 2022 Issue
SPECIAL REPORT/FREE CONTENT What do family caregivers identify as important areas for choosing care-at-home provider? What area did family caregivers identify for improvement? How are your organization’s surveys being affected? What strategies made the top of the list? What are the five ways to achieve family caregiver communication success? In this special report, we give you seven family caregiver expectations to increase your competitive advantage.
ACOs Perspective About Home-Based Care
A recent study in the Journal of Managed Care was an eye-opener when it comes to better understanding home-based care from an ACO perspective.
Legal: Antitrust Guidance for HR Professionals
It’s a new environment for anti-trust enforcement, especially in the healthcare industry. Providers should pay close attention to this issue.
Study: Increasing Your Partnership Value with Hospitals
Increase your partnership value with hospitals by leveraging this study, which showed home health vs. no post-acute care was associated with reduced 30-day readmissions and better outcomes.
Action Strategy: High-Risk Readmissions: Skilled Nursing Facility to Home
Patients discharged with heart failure from a skilled-nursing facility to home face the highest risk of readmissions in the first two days after a SNF discharge.
Action Strategy: Timely Care Transitions: Planning the Next Site of Care as The Priority
Achieving a timely transition of care while simultaneously lowering the risk of readmission remains one of the toughest challenges in the quest for value-based outcomes.
To the Point
May/June 2022 Issue
FREE CONTENT In this issue of the Remington Report, we take a deep dive into the post-acute transfer policy, the impact to your organization, what it means to hospitals, and how to drive greater value as a hospital partner.
Discharge Planning: How is a Post-Acute Transfer Defined?
May/June 2022 Issue
SUBSCRIBER CONTENT Hospitals are responsible for coding a Medicare beneficiary discharge bill based on the discharge plan for the patient. Here's what you need to know.
Data Point: Discharge Planning Codes Identify Where the Patient is Being Referred
May/June 2022 Issue
FREE CONTENT The discharge status code identifies where the patient is being discharged to at the end of their facility stay or transferred to such as an acute/post-acute facility.
Post-Acute Care Transfer to Home Health Reduced Readmissions
May/June 2022 Issue
SUBSCRIBER CONTENT A recent study published in the American Journal of Managed Care showed home health vs. no post-acute care was associated with reduced 30-day readmissions and better outcomes.
Post-Acute Transfer to a Home with Home Health Services
May/June 2022 Issue
SUBSCRIBER CONTENT Medicare’s IPPS post-acute care transfer policy requires hospitals to apply the correct discharge status code to claims where patients receive home health services within three days of discharge.
OIG Report: Medicare to Overpay More Than $267 Million
May/June 2022 Issue
SUBSCRIBER CONTENT This important OIG report has finding of hospitals that did not properly code post-acute transfer correctly.
Fast Facts About the Post-Acute Transfer Policy
May/June 2022 Issue
SUBSCRIBER CONTENT Fast facts about the Post-Acute Transfer Policy. Here's what you need to know at a glance.
Post-Acute Care Transfer Policy: The Overpayment for Discharges
May/June 2022 Issue
SUBSCRIBER CONTENT Medicare improperly paid acute-care hospitals $54.4 million for 18,647 claims subject to the Post-Acute Care Transfer policy.
Does Hospice Save Money Across All Payers?
A recent study published in the Journal of the American Medical Association of 5,464 beneficiaries reveals that total health expenditures were lower for those who used hospice.
Legal: Liability for Negligent Wound Care
To prove that providers rendered negligent wound care, patients must prove all of the following: Duty, breach, cause, and injury or damage.
OIG Report: Medicare Payments of $6.6 Billion Provided to Medicare Beneficiaries Outside the Medicare Hospice Benefit
Analysis of trends and payment patterns indicate non-hospice payments for Medicare Part A and B items and services totaled $6.6 billion from 2010 through 2019.
Legal: Non-Compete Agreement Trends
Although the trend is certainly against non-compete agreements or restrictive covenants in the health care industry, some state courts have affirmed their use.
To the Point
March/April 2022 Issue
FREE CONTENT In its 10th annual round of penalties, Medicare is reducing its payments to 2,499 hospitals, or 47% of all facilities for readmissions.
Timely Care Transitions: Planning the Next Site of Care as The Priority
March/April 2022 Issue
SUBSCRIBER CONTENT Discharge destinations require established relationships with a network of high-quality post-acute providers, facilities and home health resources in the community.
High-Risk Readmissions: Skilled Nursing Facility to Home
March/April 2022 Issue
SUBSCRIBER CONTENT Readmission after skilled-nursing facility (SNF) discharge following heart failure hospitalization is highest during the first two days home.
DataPoint: Readmissions By Payer
March/April 2022 Issue
FREE CONTENT Data Sharing: Number of readmissions, readmission rates, and average cost of readmissions
Is Socioeconomics a Main Influencer of Readmissions?
March/April 2022 Issue
SUBSCRIBER CONTENT Researchers examined the common reasons why some hospitals have more readmissions treating a disproportionate share of patients with low incomes, poor health and other negative circumstances.
30-Day Readmissions: Managing Clinical Conditions to Prevent Readmits
March/April 2022 Issue
SUBSCRIBER CONTENT The federal government’s effort to penalize hospitals for excessive patient readmissions is ending its first decade with Medicare cutting payments to nearly half the nation’s hospitals.
Hospital Readmissions, Ages 65-74, by State
March/April 2022 Issue
FREE CONTENT Percentage of Medicare aged 66-74 enrolled in Medicare fee-for-service within 30-days of hospital discharge.
Which Chronic Conditions Managed by Home Care Services Reduce Medicare Spending?
March/April 2022 Issue
SUBSCRIBER CONTENT A recent analysis determined that Medicare fee-for-service patients who received personal care services experienced a decrease in Medicare expenditures over time.
Discharge Planning Patterns: Care Transitions and Readmissions
March/April 2022 Issue
FREE CONTENT A recent study examined the patterns of Medicare beneficiaries post-acute care transitions among assisted living residents and their outcomes in the first 30 and 60 days after hospital discharge.
To the Point
January/February 2022 Issue
FREE CONTENT As the care-at-home industry continues to grow and expand, there are both opportunities and challenges in the future.
Medicare Advantage: 5 Care-At-Home Supplemental Benefits Skyrocket in 2022
January/February 2022 Issue
SUBSCRIBER CONTENT CMS’s reinterpretation of “primarily health-related” benefits has led to more Medicare Advantage (MA) plans offering services.
7 Trends Changing Medicare Advantage Plans In 2022
January/February 2022 Issue
SUBSCRIBER CONTENT CMS projects that nearly 30 million people are signing up for MA in 2022. Here are seven trends to watch for.
Trends and Patterns of Dementia Patient Discharges: SNF vs. Home Health
January/February 2022 Issue
SUBSCRIBER CONTENT One-third of all fee-for-service Medicare beneficiaries receiving post-acute care have a diagnosis of dementia, and more than 7 in 10 receive this care in a SNF.
5 Things to Know About Hospice Benefits 2022
January/February 2022 Issue
SUBSCRIBER CONTENT CMS is testing a broad array of complementary MA health plan innovations designed to reduce Medicare program expenditures, enhance the quality of care for Medicare beneficiaries
The Expansion and Shift Into Community-Based Care
January/February 2022 Issue
FREE SPECIAL REPORT Seven trends supporting growth and the future, including the expansion of community-based care and expanded clinical care models to attract referrals.
Patient Discharge: Is Your Organization Asking Hospitals, SNFs, and Physicians for “Z” Codes?
January/February 2022 Issue
SUBSCRIBER CONTENT Z codes are a set of ICD-10-CM codes used to report social, economic, and environmental determinants known to affect health and health-related outcomes.
Enforcers Continue to Target Discharge Planners/Case Managers
January/February 2022 Issue
FREE CONTENT Case managers/discharge planners continue to come under fire from fraud enforcers for violations of the federal anti-kickback statute.
Workforce Salaries: Nurse Practitioners by State
January/February 2022 Issue
SUBSCRIBER CONTENT According to the U.S. Bureau of Labor Statistics' latest occupational employment and wage statistics survey, the mean annual wage for nurse practitioners in the U.S. is $114,510.
Workforce Salaries: Home Health and Personal Care Aides
January/February 2022 Issue
SUBSCRIBER CONTENT The median annual wage for home health and personal care aides was $27,080 in May 2020, according to the U.S. Bureau of Labor Statistics.
Complaints About Referrals Must Be Based on Facts
The owner of a supplier of home medical equipment (HME) complained that her company did not receive referrals from TidalHealth Nanticoke Hospital. The Court dismissed the owner’s lawsuit because she could not prove her claims. This case illustrates why providers who complain about practices of referral sources must have facts to support their claims.
Legal: What Can Discharge Planners/Case Managers Accept from Providers Who Want Referrals?
Discharge planners, case managers, and social workers certainly cannot accept cash payments from providers in exchange for referrals of patients. But what can they accept from providers who want referrals?
Oncology Hospital-at-Home Program Reduces Readmissions and ED Visits
Launched in 2018, Huntsman at Home in Utah was one of the first programs in the United States to provide acute cancer care at home.
The Latest on Recoupment of Overpayments
In a November 2021 decision, the U,S, Court of Appeals said that CMS can recoup overpayments from providers even though its appeals are still pending before Administrative Law Judges.
Legal: What Can Providers Give to Patients?
Providers, including marketers, are tempted to give patients free items and services. But be careful! These activities may violate laws prohibiting providers that participate in state and federal health programs from giving free items and services to patients.
To The Point
November-December 2021 Issue
FREE PUBLISHER'S MESSAGE In this issue of The Remington Report, we will provide actionable insights to guide your organization forward.
GAO Report: Medicare Advantage Beneficiaries Switching to Medicare Fee-For-Service During Last Year of Life
November-December 2021 Issue
SUBSCRIBER CONTENT Medicare Advantage beneficiaries are switching to Medicare Fee-for-Service during their last year of life, according to a Government Accountability Office report.
5 Ways to Improve Medical Supply Management, Reduce Costs, and Improve Outcomes
November-December 2021 Issue
FREE CONTENT Interviews with two organizations share how they tackled challenges to improve medical supply management, reduce the cost of care, and improve outcomes.
Diabetes Rehospitalizations Tied to Timing of Home Healthcare Services
November-December 2021 Issue
SUBSCRIBER CONTENT Learn the association between the timing of home healthcare start of care and 30-day rehospitalization outcomes for Medicare beneficiaries following a diabetes-related hospitalization.
Six Real-Time Medication Reconciliation Solutions
November-December 2021 Issue
SUBSCRIBER CONTENT Four peers share solutions to improve clinical handoffs, the advantages of timely information, how to drive better outcomes, and how to boost clinical productivity.
ACOs: Five Important Facts Changing Up Participation
November-December 2021 Issue
SUBSCRIBER CONTENT Get insight into how ACOs are performing and related changes to their future.
Study: 61% of Seniors will Require Long-Term Care Services and Supports
November-December 2021 Issue
SUBSCRIBER CONTENT This study provides insight into the long-term care services and support needs of seniors that help shape the future.
Closing the Patient Communication Gap With Your Referral Partners
SUBSCRIBER CONTENT Across the board, we see from referral sources and other care providers alike that they really feel as if they’re part of the care team now instead of the end of the line where a patient goes when they get out of the hospital. Your peers share their thoughts and solutions.
Can Hospitals Require Physicians to Direct Referrals?
November-December 2021 Issue
FREE CONTENT Effective on January 19, 2021, new regulations related to the Stark laws expanded and underscored the ability of hospitals to require physicians to send referrals to particular providers. These new regulations also make it clear that providers can monitor and enforce requirements to direct referrals to designated providers.
5 Ways to Improve Medical Supply Management, Reduce Costs, and Improve Outcomes
SPECIAL REPORT Interviews with two organizations share how they tackled challenges to improve medical supply management, reduce the cost of care, and improve outcomes.
Why is It Important to Understand Hospital Stays By Medical Condition?
Your partners – ACOs, payers, commercial insurers, physicians, and health systems – seek ways to reduce hospitalizations and re-hospitalizations. A critical measurement of your value is to show how your organization can reduce the cost of care, decrease re-hospitalizations, and improve outcomes.
The Obesity Crisis and Chronic Illness Attributed to 64% of Hospitalizations
The 18th annual report by Trust for America’s Health on the obesity crisis in the United States has been released. This year, special features highlight the interaction of the COVID-19 pandemic with social, economic, and environmental conditions that impact hospitalizations, social determinants of health (SDOH), and outcomes.
To The Point
September/October 2021 Issue
FREE PUBLISHER'S MESSAGE In this issue of The Remington Report, we will guide your business readiness for adoption of new transformations, look at opportunity identification to create new revenue, and provide ways to achieve better outcomes.
The Ten Most Frequent Diagnoses for Inpatient Stays
September/October 2021 Issue
FREE CONTENT In this article, we discuss the 10 most frequent principal diagnoses and their costs impacting hospital inpatient stays.
Six Digital Health Investments: What Are the Targets?
September/October 2021 Issue
SUBSCRIBER CONTENT Learn the specific six surging areas businesses are investing in that is creating a road map to healthcare’s future.
Six Smart Ways to Stay in Communication with Your Referral Sources
September/October 2021 Issue
SUBSCRIBER CONTENT Your referral partners increasingly expect robust communications to make patient transfers as seamless as possible, for both the patient and providers. They will have to make a choice. Ultimately, they will look for relationships with organizations that are easy to work with and that can deliver proven quality care. We provide insights and strategies from high-performing organizations.
What Program is the Biggest Winner for Home-Based Care?
September/October 2021 Issue
SUBSCRIBER CONTENT Read the insights about home-based primary care and how they have reduced hospitalizations, readmissions, and emergency room visits.
Five COVID Waivers the American Hospital Association is Urging CMS to Keep That Impact Your Organization
September/October 2021 Issue
SUBSCRIBER CONTENT The American Hospital Association is urging CMS to keep five COVID waivers and to not return to the old ways of doing things.
Three Missed Opportunities for End-of-Life Discussions
September/October 2021 Issue
SUBSCRIBER CONTENT Recent research discusses the missed opportunities for discussions about end-of-life, including advance care planning, palliative care, discontinuation of disease-directed treatment, hospice care, and after-death wishes, with outpatients with advanced cancer.
Six Ways to Identify, Increase, and Manage Referrals
September/October 2021 Issue
SUBSCRIBER CONTENT In this new normal, it’s important to understand how your referral sources work, what they are sending to you versus the competition, how to deepen relationships with these sources, and what differentiates you as a provider in the marketplace.
Seamless Care Transitions: Six Smart Ways to Stay in Communication with Your Referral Sources
SPECIAL REPORT Your referral partners increasingly expect robust communications to make patient transfers as seamless as possible, for both the patient and providers, which means you need strategies to create seamless transitions. Learn what leading home health and hospice agencies are doing in this free special report.
Four Key Trends Impacting Chronic Care Management, Physician Practices, and Payers
July/August 2021 Issue
SUBSCRIBER CONTENT Four significant trends are impacting chronic care management and the future of physician groups and payers. Moving forward this can change your referral growth and the need to expand your managed care contracts.
Five Payer Strategies Ramping-up Home Care Usage
July/August 2021 Issue
SUBSCRIBER CONTENT Payers are targeting their member populations that will benefit the most from at-home care. The center of their home health offerings is focused on high-cost patients, palliative care, diabetes, home care visits, telehealth, and at-home testing.
Administering Specialty Drugs at Home
July/August 2021 Issue
SUBSCRIBER CONTENT A recent study found receiving certain forms of care at home instead of in the hospital can lower healthcare spending. Administering specialty drugs at home or in a provider’s office lowered healthcare spending by $4 billion.
Six Ways To Recharge Clinical Engagement and Work/Life Balance
July/August 2021 Issue
SUBSCRIBER CONTENT Strategies and actions to improve clinician experiences. Work/life balance is something nurses are constantly trying to achieve, and many nurses are falling short of that goal. What solutions are your peers using to combat burnout, achieve better nurse work/life balance, and improve patient care?
Nine Payer and State Medicaid Managed Care Investments in Social Determinants
July/August 2021 Issue
FREE CONTENT In this article, we take a look at social determinant insights and investments from the perspective of Medicare Advantage plans, Medicaid managed care and healthcare providers.
Participation in Payment Reform and Delivery Falling Short By Primary Care Organizations
July/August 2021 Issue
SUBSCRIBER CONTENT Primary care transformation in voluntary programs has failed to broadly engage primary care organizations. What’s causing the low participation?
3 Secrets for Accelerating Home Health and Hospice Growth and Referrals
July/August 2021 Issue
SUBSCRIBER CONTENT How to empower your team, drive efficiency of care, prevent readmissions, and gain a competitive advantage for your home health and/or hospice agency.
6 Ways to Identify, Increase, and Manage Referrals
The Remington Report presents six ways to accelerate home health and hospice growth through improved referral processes, including questions you should be asking your referral sources.
Telehealth’s Future for Medicare and Medicaid Managed Care
A new report from the GAO titled, "COVID-19 Program Flexibilities and Considerations for Their Continuation," investigates the future of telehealth
6 Ways to Recharge Clinical Engagement and Work-Life Balance
SPECIAL REPORT Work-life balance is something nurses are constantly trying to achieve, and many nurses are falling short of that goal. Here, then, are strategies and actions to improve clinician experiences.
Legal Perspective on Patient Choice
What are the fraud implications when patients' rights are violated? What is the role of physicians in patients' freedom of choice? The Remington Report gets answers from Attorney Elizabeth Hogue.
3 Secrets for Accelerating Home Health and Hospice Growth and Referrals
SPECIAL REPORT How to empower your team, drive efficiency of care, prevent readmissions, and gain a competitive advantage for your home health and/or hospice agency.
The Care at Home Market Shake-Up
May/June 2021 Issue
Payers, health systems, Private Equity firms, and SPAC’s acquisition of care at home companies are quickly changing market dynamics, and signaling change is ahead. This is a must-read to understand trends and insights reshaping the future.
The Four Frustrations Your Referrals are Voicing. Is Your Organization Losing Referrals?
May/June 2021 Issue
Your referral sources are the lifeblood of your organization. Ultimately, they will look for relationships with organizations that are easy to work with and that can deliver proven quality care. A new research report reveals the four frustrations felt by your referral sources. A roundtable of your peers' weigh-in with solutions.
Advance Care Planning: Pilot Studies for Care at Home Providers
May/June 2021 Issue
The National Institute of Health advance care planning studies are focusing on the effectiveness of telehealth for patients receiving home-based palliative care and leveraging in home support services to engage patients in advance care planning. Learn more about the pilot studies supporting this research.
What Legal Parameters Establish Patient Choice?
May/June 2021 Issue
The right of patients to choose providers has generated considerable conflict within the provider community. In this article, learn the four key legal sources supporting patient choice and actions your organizations and patients can take to have them enforced.
Are CMS Payment Models Delayed … Or Gone Forever?
May/June 2021 Issue
A review of payment models under CMS’ Center for Medicare and Medicaid Innovation (CMMI) is quietly under review to decide if they will be implemented. Many of these models were popular with care at home providers. We provide insight into each of these payment models.
The Top Six Strategies to Grow and Manage Referral Partners
May/June 2021 Issue
The Remington Report interviews Nick Knowlton to discuss how to manage referrals, grow referrals, exchange communications with referrals, and gain a competitive advantage.
The Four Frustrations Your Referrals are Voicing: Is Your Organization Losing Referrals?
SPECIAL REPORT What referring hospitals, ACOs, and physicians want from home health, hospice, palliative care and private duty providers to make their lives easier.
5 Top Strategies to Grow and Manage Referral Partners
SPECIAL REPORT For five top strategies, we discuss actionable steps that can be taken by home health, hospice, palliative care, and private duty organizations to gain a competitive advantage.
Solutions to Building a Palliative Care Program in the Ambulatory Care Setting
Educational materials, tools, training, and resources for integrating palliative care into ambulatory care for patients with serious life-threatening chronic illness or conditions.
Market Signals Broaden Continuum-of-Care Services
March/April 2021 Issue
Expanding continuum of care services is an important strategy for future market positioning. We explore how providers, payers, and physicians are broadening services to expand partnership referrals, create innovation, and ensure sustainability.
Does Your Organization Have the Right Clinical Service Lines to Reduce the Cost of the Top Five Medical Conditions and Expenditures?
March/April 2021 Issue
New information will help your organization better align clinical services to reduce the cost of the highest medical conditions and their expenditures. The data can be used in conversations with various payer sources to align your organization’s services to reduce the cost of care and readmissions.
How Community-Based Care is Being Redefined
March/April 2021 Issue
Under Andrew Molosky’s leadership, Chapters Health System has combined innovation and creative disruption to shift end-of-life care into a leading community-based population health organization.
Legal Use of Consulting Physicians/Medical Directors: Practical Issues
March/April 2021 Issue
Post-acute organizations need consulting physicians’ services. The OIG continues to scrutinize these relationships. What are the three things providers should know before signing agreements?
How to Accelerate Business Growth and Technology Innovation for Home Health, Hospice, Palliative Care, and Private Duty Providers
March/April 2021 Issue
National leaders discuss how to lean into new approaches to accelerate growth, improve performance, and address technologies that create faster reimbursement, better work-life balance for clinicians, and optimal patient outcomes.
Vital to Survival Business Intelligence: Operational, Financial, and Clinical
SPECIAL REPORT The compelling ways business intelligence drives actionable results.
4 Strategies to Dramatically Improve Productivity, Volume, and Revenue
SPECIAL REPORT National leaders discuss how to lean into new approaches to accelerate business growth, improve performance, and address technologies that create faster reimbursement, better work-life balance for clinicians, and optimal patient outcomes. They share how their organizations address four key questions.
OIG’s Audit: Home Health Telehealth Payments
On a temporary basis, CMS issued blanket Section 1135 to healthcare professionals in response to the COVID-19 public health emergency (PHE). But now the OIG wants to be sure the rules are being followed. This Remington Report special report dives into the subject of home health telehealth payments.
How Community-Based Care is Being Redefined
SPECIAL REPORT The shift from end-of-life care to building a continuum-based approach, plus strategies for growth, market position, and innovation revealed.
7 Models That Will Accelerate Value Based Payments in 2021
This year, several value-based payment models will begin the shift from fee for service to value-based. Earmark this as the transformation of payment reform for care-at-home providers and how they will be paid in the future. This white paper explains the seven value-based models impacting care-at-home providers.
Should Your Organization Be Preparing for Greater Value-Based Payments?
January/February 2021 Issue
Beginning in 2021, several value-based payment models will begin the shift from fee-for-service to value-based. Earmark this as the transformation of payment reform for care at home providers and how they will be paid in the future.
How is Your Organization Prepared to Participate in New Non-Traditional Care-at-Home Models?
January/February 2021 Issue
New choices to receive care at home centers on patients receiving acute level care in the home. Non-traditional care at home models is expanding into a new era. The twist to non-traditional programs is to keep care at home leadership’s eyes wide open about the impact to their organizations. Waivers are changing rules, policies have changed, and the role of who can care for patients in the home is transforming models.
How is Technology Expanding Care at Home and How Does it Effect Your Organization’s Future?
January/February 2021 Issue
The invisible technology boundaries expand the rules of who can offer care in the home, how they will be paid, and it creates a less restrictive policy environment to deliver care at home. The opportunity to reshape care delivery and create a more efficient and cost-effective healthcare system is achievable because of the acceleration and adoption of technology.
How is Your Organization Rethinking Strategic Positioning to Offer Continuum-of-Care Services from Pre- And Post-Discharge to End-of-Life?
January/February 2021 Issue
The question for leadership is how do you want to position your organization? As an integrator? Or as an aggregator? For care at home providers, the goal is to create a post-acute continuum model as patients transition from one care setting to another whether that be in-home personal care services, skilled home health, palliative care, or hospice.
2021 Regional Outcomes for Medicare Require Full Financial Risk
January/February 2021 Issue
Geographic direct-contracting model (GEO) is the latest CMS Center for Medicare and Medicaid Innovation (CMMI) model which allows Direct Contracting Entities to accept full financial risk for all traditional Medicare enrollees in their region. Three options enhance Medicare benefits and provide waivers for care in the home.
2021 Healthcare Outcomes Go Statewide and Regional
January/February 2021 Issue
A growing number of initiatives are expanding to address social determinants of health. Payers, health systems, community-based organizations, and government entities are partnering together to create statewide efforts to improve community health and social care.
DATA POINT: 2021 Medicare Advantage Membership Growth Continues to Outpace Medicare Fee-For-Service Growth
January/February 2021 Issue
Medicare Advantage growth continues to outpace overall Medicare FFS membership growth, according to the latest statistics.
DATA POINT: Why Does Primary Care Spending Matter?
January/February 2021 Issue
Why should we be concerned that primary care spending appears to be declining? A growing body of evidence measuring health system performance and population health outcomes finds that greater primary care is associated with better value: enhanced population health outcomes, greater equity, and more efficient use of healthcare resources.
2021 Payer Opportunities Collection
Your organization has new opportunities to grow and expand payer partnerships. A one-size-fits-all approach no longer exists, which is why we have bundled four articles from the Nov-Dec 2020 issue of The Remington Report into this complimentary compendium. Read about how to expand internal and external education, leverage critical investments in your workforce, and enhance actionable data needed by payers.
Physicians Expanding Care Into the Home
Home-based medical care models are shaking-up the $260 billion primary care market. Three physician models, new reimbursement models, telehealth, and chronic care management are key drivers.
COVID-19 Readmissions
In this free industry report, The Remington Report provides key data analysis to help your organization mitigate COVID-19 readmissions, along with five action steps for your organizations to explore.
Physicians are Expanding Care Into the Home
November-December 2020 Issue
Home-based medical care models are shaking-up the $260 billion primary care market. Three physician models, new reimbursement models, telehealth, and chronic care management are key drivers.
Payers Expanding Care at Home Models
November-December 2020 Issue
Building home care capacity will give plans more flexibility to meet patients on their own terms and could improve outcomes. Learn what is changing models of care in the home.
State Medicaid Programs are Expanding Value-Based Payments
November-December 2020 Issue
States are developing plans to increase Medicaid provider participation in and adoption of value-based care models. How will these new payment models work?
Medicare Advantage Plans Expand Supplemental Benefits
November-December 2020 Issue
Medicare Advantage Plans are expanding supplemental benefits in 2021. Learn what services are expanding and how this expands your partnerships.
Medicaid Managed Care are Linking Bonus Programs Tied to Performance
November-December 2020 Issue
States are expanding value-based payments (VBP) in Medicaid and leveraging their Medicaid managed care programs to advance their payment reform goals. We discuss the details.
New Care Models Allow Payers to Take on Risk for Dual-Eligible Beneficiaries
November-December 2020 Issue
CMS' innovation center (CMMI) is about to roll out a new model allowing insurance plans to take on financial risk for patients enrolled in both Medicare and Medicaid. How will this affect payers? What other new models can you expect in the future?
Expanded Access for Rural Communities and Transformation of Care
November-December 2020 Issue
The Community Health Access and Rural Transformation (CHART) Model expands telehealth services, links residents to non-local healthcare providers, and provides more than $8.7 million in grant funding. What are the new opportunities for your organization?
COVID-19: The Triumphs and Challenges
November-December 2020 Issue
Compelling stories from your peers talk about their experiences with COVID-19 and their patients.
COVID-19: Overseeing Multiple Conditions
November-December 2020 Issue
We share a collection of stories from caregivers on the frontline overseeing patient care for multiple conditions at home: dementia, end-of-life, behavioral health, and falls.
COVID-19: Overcoming Fear and Showing Strength
November-December 2020 Issue
This collection of stories shares how caregivers overcome the challenges of treating patients during COVID-19.
OIG Says Providers Can Offer Services to Caregivers
November-December 2020 Issue
In Advisory Opinion No. 18-05; issued on June 18, 2018; the OIG addressed the circumstances under which providers can establish “caregiver centers” that provide or arrange for free or reduced-cost support services to caregivers in local communities.
6 Ways Care in the Home is Changing Your Business
In this free industry report, The Remington Report shares six ways care in the home is changing the future of healthcare. Leaders will need to address these strategically if they intend to realize continued growth in a significantly changing marketplace.
The No. 1 Reason Why Patients are Not Getting Home Health Care After a Hospital Discharge Referral
In this free industry report, The Remington Report unveils the major reason why patients are not getting home health care after a hospital discharge referral, plus four strategies you can use to boost referrals.
Four Ways to Combat the Under-Utilization of Home Health and Hospice
In this free industry report, The Remington Report offers up four strategies to increase the utilization of home health and hospice in the age of COVID-19.
Home-Based Primary Care: It’s Time to Think Beyond the Clinic Walls
September/October 2020 Issue
Primary care is being rapidly redefined today right before our eyes. As healthcare evolves, patient needs expand and providers must look for new and better ways to achieve a patient-centered model of practice. Read the four reasons home-based primary care is opening doors and opportunities for patients and providers today.
DataPoint: 40% of Americans Delay Care
September/October 2020 Issue
How is COVID-19 delaying care? Nationwide 40% of Americans are still delaying care according to a survey from the U.S. Census Bureau.
Telehealth: 2021 New Billing Codes for Physician Home Visits and Care Planning
September/October 2020 Issue
CMS has released proposed policy changes for 2021 Medicare payment rates under its annual Physician Fee Schedule. Telehealth codes allow physicians to bill for home visits and care planning. We dive into the codes and what they mean.
Home-Based Primary Care Models are Disrupting the Traditional Primary Care Market
September/October 2020 Issue
Home-based medical care models are shaking-up the $260 billion primary care market. How are integrated primary care delivery models addressing chronic care management in the home?
The Vulnerabilities of COVID-19 Expand Insurers Capabilities In the Home
September/October 2020 Issue
Insurers' strategies to provide greater services in the home are moving rapidly. Changing models have insurers partnering-up with primary care physicians, telehealth, and pharmacies to deliver care in the home. We provide insights to insurers' reactions post COVID-19 and beyond.
Stronger Strategic Partnerships: Data Exchange is a Driving Factor
September/October 2020 Issue
Payers are interested in talking about the data. In particular, they are interested in understanding how home care providers are able to reduce their penalties and increase their rewards in a value-based payment system. Learn how one organization is advancing conversations.
Marketing Hospice Service to ALF: Preferred-Provider Agreements
September/October 2020 Issue
How do anti-kickback statutes apply if providers or Assisted Living Facilities (ALFs) are involved in referral arrangements and receive any type of federal or state funds? Attorney Elizabeth Hogue breaks it all down.
Strategy Insight: How To Align Financial and Clinical Incentives with Payers and the Most Costliest Medical Conditions
In this article, we take a look at data reflecting the costliest medical conditions by payers. This becomes an important strategy as payers begin to move more value-based care contracting into the home care space and look to treating higher acuity patients in the home.
COVID-19 Discharge Status Reveals Under-Utilization of Home Health and Hospice Services
CMS released a data snapshot of COVID-19 hospitalizations, length of stay, and discharge status for 109,607 patients. Payer sources include Fee-for-service (FFS) claims data, Medicare Advantage (MA) encounter data, and Medicare enrollment information.
Legal: Managing the Risks of Wound Care
Wound care is a risky business these days. Providers who render wound care services are at risk for many things, including liability for negligent wound care, violation of fraud and abuse prohibitions based on substandard wound care, and liability for abandonment when wound care services are discontinued.
Industry Business News
CMS has made three new appointments to their quality division, the Visiting Nurse Service of New York has settled its lawsuit, and Orlando Health and LHC Group has inked a partnership. The latest executive moves in healthcare, along with other industry business news, can be found here.
Telehealth’s Outlook Beyond COVID-19
July/August 2020 Issue
Telehealth is healthcare’s hottest topic. How should providers support and drive growth? What new opportunities will improve outcomes? How will telehealth reshape care delivery?
DataPoint: Medicare Advantage Penetration Reaches 36% in 2020
July/August 2020 Issue
Medicare Advantage penetration continued to grow following the 2020 Medicare Annual Election Period, reaching 36.0% in 2020, according to CMS’s March data release.
COVID-19 Telehealth Expansion to Access Essential Health Services
July/August 2020 Issue
How can home care optimize telehealth during COVID-19 to work with other stakeholders and maintain continuity of care? What strategies can increase uptake and new models?
COVID-19 Case Study: Intermountain Healthcare’s Hospital-Level Care In Patients’ Homes
July/August 2020 Issue
Intermountain at Home’s hospital-level care in patient’s homes supports their health system in the event of a surge of COVID-19 patients. Their models include home-based post-hospital care, palliative, and end-of-life care as well as medical equipment maintenance.
COVID-19 Medicare Emergency Waivers For Discharge Planning And Home Care Providers
July/August 2020 Issue
CMS has provided blanket waivers with a retroactive effective date of March 1, 2020 through the end of the emergency declaration to help providers during COVID-19. We gathered the waivers for discharge planning, in-home care providers, and other post-acute care settings.
DataPoint: Almost 90% of COVID-19 Admissions Involve Comorbidities
July/August 2020 Issue
The hospitalization rate for COVID-19 is 4.6 per 100,000 population, and almost 90% of hospitalized patients have some type of underlying condition, according to the Centers for Disease Control and Prevention (CDC).
CommonSpirit Health at Home Reinvents Virtual Telehealth Monitoring
July/August 2020 Issue
CommonSpirit Health at Home provides another layer of protection and defense to keep vulnerable patients safe, healthy, and in their homes during this pandemic. And, it positioned to play a key role in preventing a post-COVID surge at care sites. Learn how CommonSpirit at Home expanded its virtual monitoring capabilities to better respond to patients’ needs during and beyond the COVID-19 pandemic.
COVID-19: Reauthorization of the Older Americans Act (OAA)
July/August 2020 Issue
The reauthorization of the Older Americans Act (OAA) was perfect timing when COVID-19 reared its ugly head. Last March, President Trump signed a bipartisan reauthorization of a landmark law that provides more money for programs that help millions of older Americans age in their homes and communities through services including Meals on Wheels, family caregiver support, and transportation.
Seniors Using Telehealth in Medicare Advantage Plans are Highly Satisfied
July/August 2020 Issue
Amid COVID-19 pandemic, 91% of Medicare Advantage beneficiaries using telehealth report favorable experiences while a record-setting 99% express satisfaction with their MA plan. 78% are willing to use it again.
COVID-19 Discharge Planning Waivers Link to Patients’ Freedom of Choice
The Centers for Medicare and Medicaid Services (CMS) has issued a number of waivers of various requirements for healthcare providers related to discharge planning for hospitals and critical access hospitals (CAHs).
Payers: 2020 Supplemental Benefits for Chronic Conditions Doubled
In 2020, Medicare Advantage (MA) plans have doubled the number of condition-specific supplemental benefits from approximately 820 to 1,850. However, the new Special Supplemental Benefits for the Chronically Ill (SBBCI) for 2020 didn’t fare as well.
Physician Assistant Workforce Under Turmoil
Twenty-one states have taken action to suspend or waive certain practice requirements for physician assistants in response to COVID-19.
COVID-19 Healthcare Workforce and Revenue Reductions: U.S. Home Health Workforce
A recent survey across the U.S revealed the devastation of reduced revenue, patient’s refusal to accept physician-ordered care, and loss of the workforce.
COVID-19 Healthcare Workforce and Revenue Reductions: Aides and Personal Care Workforce
3.5 million low-wage workers are in the health and social services industry, with the greatest number of those (1.3 million) working as aides or personal care workers
COVID-19 Healthcare Workforce and Revenue Reductions: Physician Workforce
The data from the Bureau of Labor Statistics found dentists' offices had the most losses with 503,000. Physicians' offices lost 243,000.
COVID 19: Proactive Post-Acute Solutions for Health Systems and Physicians
May/June 2020 Issue
In our interview with Paula Thompson, RN, MS, CRNI, President and CEO of Fidelity Health Care, we learn how her organization has advanced partnerships with five health systems and physician practices.
COVID 19 The Time is Now! Do More to Demonstrate the Value of Post-Acute Care
May/June 2020 Issue
Anxiety levels are high right now. The COVID-19 outbreak has overtaken our lives, affecting everyone, but especially our patients and families. We no longer have the comfort of a normal routine, and there is no end in sight from this unprecedented pandemic.
DME: The Forgotten Frontline in the COVID-19 War
May/June 2020 Issue
Is COVID-19 identifying a major gap in DME services? As hospitals discharge patients into their homes or other residential settings to free-up resources and hospital beds, the resultant strain on the provision of DME items and services, particularly for suppliers of home oxygen and ventilators, will significantly increase. Read about unintended consequences.
COVID 19 and Beyond: The Role of the Respiratory Therapist in Post-Acute and Home Care
May/June 2020 Issue
COVID-19 quickly identifies gaps in the health care delivery system. In the acute care hospital, the Respiratory Therapists (RT) is a well-respected team leader in respiratory care. Yet as soon as that patient is discharged, they suddenly lose that supportive RT expertise.
COVID 19: Key Legal Issues
May/June 2020 Issue
It’s an important time to review legal questions and issues related to COVID-19. There is a lot of mis-information flying around and it’s easy for providers to get tripped up. But providers must ensure that they are doing it right in order to avoid a day of legal reckoning that could threaten their businesses in the future.
COVID-19: Broadening Telehealth Solutions
May/June 2020 Issue
MaineHealth Care at Home began using telehealth in 2001. In our Interview with Donna DeBlois, RN, BSW, MSB, MBA, AHCA, President of MaineHealth Care at Home, we learn how her organization is expanding telehealth to a broader patient population under COVID-19.
COVID-19: End-of-Life Care for Patients and Providers
Are health care systems, patients, and families prepared for tough conversations and decisions about health care preferences and medical interventions?
COVID-19: Protecting Healthcare Workers
Concern for healthcare workers in every setting knows no bounds! Providers' imperative is clear: everything possible must be done to keep them safe.
COVID-19 Best Practices Infection Prevention: Compliance and Training
COVID-19 training and prevention resources at your fingertips. You will find these resources important for compliance and infection prevention.
Payment Recommendations for 2021
In its March 2020 report to the Congress, MedPAC makes payment policy recommendations for provider sectors in fee-for-service (FFS).
Report: Medicare’s Hospital Post-Acute Care Transfer Policy to Hospice
The Bipartisan Act (BBA) of 2018 Act updated the hospital transfer policy for early discharges to hospice care. The law required that, beginning in FY 2019, discharges to hospice care would qualify as a post-acute care transfer and be subject to payment adjustments.
Payers Advancing Knee Replacement Care Into the Home
Aggressive moves by payers teaming up with big players such as CVS are advancing their healthcare programs into the home. How does this impact healthcare organizations?
Case Study: Payer and Provider Model: Managing Higher Acuity in the Home
Landmark estimates about 20 percent of chronically ill patients currently experience a gap in the care they are receiving, which can be addressed through medical care, support and education provided in the home.
Medicare’s Option to Avoid the Emergency Department
The Center for Medicare and Medicaid Innovation’s Emergency Triage, Treat, and Transport (ET3) Model is designed to test expanded care destination alternatives to the ED for Medicare beneficiaries who call 911.
Hospital-Level Care in the Home Lowered Costs and had Better Outcomes
A recent study in the Annals of Internal Medicine found that at-home patients fared better than those in the hospital when it came to price and outcomes.
Peer Case Study: Community-Based Paramedicine Model
CMS recently announced the Emergency Triage, Treat, and Transport model, which provides greater flexibility to ambulance care teams to address emergency health care needs of certain Medicare beneficiaries following a 911 call.
CMS Is Rolling Out Community Care Corps: Volunteer Caregivers
How can providers offer support for caregivers? A key way for providers to assist may be to collaborate with charitable organizations in the community.
Encompass Health Case Study
Encompass Health, in collaboration with McKesson, saved 17% to 19% on their supply spend, increased efficiencies, and achieved greater patient satisfaction.
Medicare Advantage Plans Proposed Rules 2021-2022 Changes Care Management Requirements
Medicare Advantage and Part D programs for contract years 2021 and 2022 has provisions changing care management requirements for special needs plans.
Patients’ Right to Freedom of Choice of Providers – Unexpected Allies
Post-acute providers, patients, and their families have very successfully raised issues with hospital administrations related to patients' right to choose.
8% Physical Therapy Cuts Questioned By Lawmakers
Nearly 100 U.S. lawmakers submitted a letter to CMS concerned about proposed cuts in Medicare payments for physical and occupational therapy services.
End-Stage Renal Disease Beneficiaries Can Enroll in Medicare Advantage Plans
In a proposed rule issued on February 5, CMS announced that beneficiaries with ESRD will be able to enroll in Medicare Advantage Plans starting in 2021.
Medicare Advantage Plans Expanding Telehealth Usage
CMS issued a proposed rule and the Advance Notice Part II to further strengthen and modernize the Medicare Advantage and Part D prescription drug programs.
Five Ways Post-Acute Providers Can Partner With Physicians
Physicians are thinking more seriously about how to succeed in the MIPS Cost category. Consider these 5 ways to help physicians reduce costs in healthcare.
CMS Combining Post-Acute Compare Websites Into One
CMS is planning to combine and standardize eight separate Compare websites into one point of entry, offer Medicare beneficiaries a consistent look and feel.
Fraud and Abuse Enforcers Target Discharge Planners Again
Recent federal cases make it quite clear that marketers for home health companies and discharge planners/case managers must just say, "NO!" The "jig is up."
2020 ACOs Taking on More Risk
The number of ACOs taking on risk for cost increases grew from 93 ACOs at the start of 2019 to 192 at the start of 2020.
Insight Report: Payment Recommendations 2021
The Medicare Payment Advisory Commission recommended that Congress reduce the payments for Home Health by 7% in 2021.
Largest Home-Based Cardiac Rehab Reduces Readmissions to Less Than 2%
Kaiser Permanente’s virtual cardiac rehabilitation program has enrolled more than 2,300 patients, making it one of the largest such programs in the U.S.
More Deaths Occur in the Home vs. Hospital and Nursing Facilities
For the first time since the early 20th century, the home has become the common place among American’s dying of natural causes.
Post-Acute Business Industry News
Post-acute ACO adds 200 new long-term care facilities, new appointments, home medical equipment acquisitions, mergers and acquisitions, and more.
2020 Senior Living Communities Are Aligning with Medicare Advantage Plans to Address High-Cost, High-Need Patients
An integrated program of services can contribute to reducing the cost of care and services to Medicare beneficiaries residing in seniors housing.
Arrangements with Referring Physicians and Home Care Providers: Recent Action
Now is the time for all home care providers to review agreements and their practices with regard to payments to referring physicians.
Industry Business News
LHC Group announces senior management change, and Amedisys acquires Asana Hospice.
2020 New Models For Chronic Care Management In The Home
The tides are shifting the expectations of home care. Pressure from reimbursement, shifting payment models, and value-based care are driving the change.
Physical Therapists Facing Layoffs Across the Healthcare Industry
Physical therapists once in such high-demand are facing massive layoffs across the industry because of reimbursement changes to skilled nursing facilities .
Chronic Care Management Payments Expand Under The Final 2020 Physician Fee Schedule Quality Payment Program
CMS is increasing payment for transitional care management services provided after discharge from an inpatient stay or certain outpatient stays.
Prior Authorizations: The Saga Continues For Providers
Starting November 1, UnitedHealthcare will not pay for unplanned surgeries in an outpatient setting unless it determines the site is medically necessary.
Insight and Analysis of Physician Reimbursement Changes 2020 and Beyond
What post-acute care providers need to know about a new rule that includes updated payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule.
Physician Stark Law Rules Revamped: New Rules Address Care Coordination
The new rules will give providers in value-based arrangements greater certainty and ease the compliance burden for providers across the industry.
Proposed Stark Law Reform: What It Means To Post Acute Providers
The proposed rules recognize that incentives are different in a healthcare system that pays for value rather than the volume of services provided.
Fall Prevention: Second-Leading Diagnosis For Readmissions
Falls were the leading reason for readmission among patients whose initial hospital was fall-related and who were discharged to home, even with home care.
Fall Prevention: Second-Leading Diagnosis For Readmissions
Falls were the leading reason for readmission among patients whose initial hospital was fall-related and who were discharged to home, even with home care.
Medicare Advantage Plans: 11 Major Changes In 2020
Private Medicare plans will soon include expanded plan options for seniors, more telehealth, and innovative plan designs and payment models.
Discharge Planning: Adding Caregivers Reduces Readmissions
Including unpaid caregivers into discharge planning for the elderly patient population reduces readmissions.
Discharge Planning Process Requires Post-Acute Quality Measures And More
New Discharge Planning Conditions of Participation require hospitals to assist patients, their families/caregivers in selecting a post-acute care provider.
Medicare Advantage Plans Add New Risk Codes For Dementia
Medicare Advantage (MA) Plans are adding two new dementia codes in their risk adjustment payment system and expanding flexibility in the MA benefit design.
Post-Acute Unified Value-Based Incentive Program: 5% Withhold Recommended
A unified value-based incentive program for SNFs, home health services, inpatient rehabilitation facilities, and long-term care hospitals is recommended.
Care Management Challenges and Barriers for High-Cost Medicaid Beneficiaries
A GAO report explored the efforts to manage high-expenditure beneficiaries, which are 5% of all Medicaid beneficiaries but nearly half of all expenditures.