Federal Innovations in Health Policy and Delivery Discussed at March on Washington
April 8, 2016 04:40 PM
With care in the community at the center of significant current and planned innovations, a session at the March on Washington Conference titled, “Federal Innovations in Health Policy and Delivery,” looked at these innovations and their impact on care in the home. The purpose of the session was to identify policy trends in care, payment bundling, shared-risk payment models, as well as quality improvement initiatives and care integration.
The session featured a panel of policy experts from the National Association for Home Care & Hospice (NAHC) including Mary K. Carr, Vice President for Regulatory Affairs, Theresa M. Forster, Vice President for Hospice Policy & Programs, William A. Dombi, Vice President for Law, and Andrea L. Devoti, Chairman of the NAHC Government Affairs Committee, as well as Lynn C. Jones, President of Christiana Care Visiting Nurse Association.
Jones said that their current involvement with innovations includes participation in several of the Bundled Payments for Care Improvement (BPCI) bundles; the Independence at Home demonstration; and a Shared Savings Program Accountable Care Organization. The bundles include joint replacement, heart failure, as well as cervical, spine, and cardiac valve surgery. “From a health care perspective, we are seeing more patients,” Jones said. “We have been able to move our percent of patients that go to SNF after joint replacement from 30 percent down to about 20 percent.” In addition, he said, “Our readmission rates had been low but they are even lower now.”
In response to a question posed by Dombi regarding which of the innovations are most important to pursue, Jones said “all of the above.” He added, “If you stick to adding value, getting costs down, and providing the care where patients want to be, it’s going to serve you well.”
Devoti, who is also President and CEO of Neighborhood Health Agencies, Inc. located in southeastern Pennsylvania, spoke about their experience with Medicare Care Choices. While she said in some ways it has been “exciting” relative to working with really well qualified staff, she also spoke about a variety of challenges including the fact that they were not asked about the design in advance.
With regards to palliative care, Forster said, “This is a case where health care providers are sort of leading the way. Medicare is at a point where there is tremendous hesitancy to create new benefit structures, and so in the interim everyone sees that there is this gray area between curative care and the decision to cease curative care that is palliative care. I think that the hospitals certainly caught wind of the value of doing this, and it has been growing tremendously in hospital systems across the nation. But you also see the same level of innovation when it comes to home health programs and hospice programs.”Forster added, “I think that the innovation is going to continue as long as it’s not prohibited.”
Carr added her perspective on the potential for home care in these innovations. “I do think these programs are going to help to highlight the value of home care,” she said.