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NAHC Report: Issue# 2271, 9/11/2013
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CMS Issues Changes to Home Health Beneficiary Notices
CMS Study Evaluates Utilization among Dual Eligibles
For Your Information: NAHC’s Annual Meeting Education Tracks in Focus: Home Health
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CMS Issues Changes to Home Health Beneficiary Notices

The Centers for Medicare & Medicaid Services (CMS) has released Change Requests 8403 and 8404 that announce changes to the Home Health Advanced Beneficiary Notice (HHABN) and instructs agencies on the use of the Advanced Beneficiary Notice (ABN) and the Home Health Change of Care Notice (HHCCN).

In their effort to “streamline, reduce, and simplify notices,” the CMS has eliminated the HHABN. The liability format of the HHABN (Option Box 1) will be replaced with the existing ABN, the form currently used by other Medicare providers to notify beneficiaries of Medicare non-coverage as required by the Social Security Act.

The HHCCN, a new form, has been created to notify beneficiaries of reductions in service for other reasons as required by the Lutwin v. Thompson decision. The HHCCN will replace both Option Box 2 and Option Box 3 formats of the HHABN.

Agencies may begin using the ABN and HHCCN now, but must use these forms to notify Medicare beneficiaries of any financial liability and /or changes in care beginning December 9, 2013. For items and services provided on or after December 9, 2013, the HHABN will no longer be valid.

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NAHC’s Annual Meeting Education Tracks in Focus: Home Health

This year’s Annual Meeting – being held October 31 – November 3 in Washington, DC – has a wide range of educational sessions for professionals in every segment of the home care and hospice community.

Below is a sampling of the many educational offerings available for those pursing the Private Duty track:

2014 Rebasing: Strategies to Counteract Constant Cuts while Improving Quality of Care

Rebasing of the home health episode payment rate beginning in 2014 has serious implications for providers and the patients served. This session will provide information and guidance on rebasing principles, strategies for improving care practices while implementing changes, and the achievable positive results that can be obtained.

Practical Measures to Ensure Compliance

Oversight of home health care and hospice has increased greatly in Medicare and Medicaid. The best defense is a good compliance offense. Learn the common documentation flaws and operational practices that could increase your compliance risk. Expert faculty will recommend best-practices for proactively managing risks and program effectiveness.

2014 … A Watershed Year!  What Does It Hold For You?

Homecare agencies have experienced significantly reduced margins in 2012 and continuing into 2013.  Revenue rates are diminishing yet costs, especially those related to staff, are increasing. Regulatory changes and agency attempts to downsize or right size have often reduced efficiencies and productivity.  2014 will be the first year of rebasing, with the potential of further Medicare rate reductions and the second year of “Transitions in Care”.  Even facing these challenges - there are opportunities!

Improved process and care management efficiencies, increased case capacity and visit productivity, higher levels of field staff satisfaction, greater earnings, better patient outcome and HH-CAHP scores, and improved case weight accuracy and financial outcomes are all achievable but it will take excellent leadership and management.  A “Transitions in Care” product-line can prove to be very rewarding to develop key partnerships with those hospitals challenged with the “Transitions” penalties and the variable cash cost of the related vacated days.  This program will discuss positive approaches to take advantage of these opportunities.

How to Maintain Your Margin and Still Provide Superior Quality Care

The participants in this program will learn about managing their margins for both hospice and home care without loosing the quality scores and care that the patients deserve. The presenters will discuss benchmarking of data and outcomes that one agency uses to ensure that the care provided is both high-quality and cost effective.

“We have so many battles we’re fighting…We need to be here and make our voices loud and heard,” said Andrea L. Devoti, NAHC’s Chairman of the Board. “Please join me in Washington October 31 – November 3. We’re going to have a great time and we’re going to make a lot of noise.”

To review all of the Private Duty sessions being offered at this year’s Annual Meeting, please click here.

To register for this year’s Annual Meeting, please click here.

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CMS Study Evaluates Utilization among Dual Eligibles

In August, the Centers for Medicare & Medicaid (CMS) released a study titled Effect of Long-term Care Use on Medicare and Medicaid Expenditures for dual Eligible and Non-dual Eligible Elderly Beneficiaries.  Among other things, the study evaluated differences in case mix and expenditures of dual and non-dual beneficiaries in the community setting receiving Medicaid long-term care (LTC) and medical services, and compared institutional and community expenditures for LTC. 

Study Focus

While recognizing dual eligibles as “a heterogeneous group,” the study focused on utilization of services for older people enrolled in fee-for service (FFS) Medicaid and Medicare.  Specifically, the study sought to analyze the role of case-mix and long-term care setting in determining medical and LTC costs for dual eligibles.  Medicaid medical expenditures included ambulatory care, hospice care, inpatient care stays, labs/x-rays/rehabilitation, physical therapy/occupational therapy/speech-language pathology therapy, and primary care case management.  Medicaid LTC costs included home health services, intermediate care facility services, personal care services, state plan payments towards nursing facility services, targeted case management, and transportation.

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