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NAHC Report: Issue# 2490, 8/18/2014
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Home Infusion Demo Maps A Way Forward For Future Medicare Changes
EEOC Expands Protections for Pregnancy and Pregnancy-Related Conditions
For Your Information: Voting Open through September 30 for Top Home Care & Hospice Nurse of the Year
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Home Infusion Demo Maps A Way Forward For Future Medicare Changes
The following article was written by Beth Mantz Steindecker, Vice President, Health Care Analyst at Washington Analysis, an institutional research firm

A Medicare demonstration project bundling payment for home infusion of intravenous immune globulin (IVIG) maps a potential way forward for future reimbursement changes involving home infusion more broadly, which would benefit larger providers like BioScrip, Walgreen, CVS, Express Scripts, privately-held Diplomat that recently filed an S-1 and privately-held AxelaCare Health.  While the demonstration will have limited impact in the near term, given that insurers tend to piggy back on Medicare even though it comprises less than 15-20% of the industry payer mix for specialty home infusion providers, the policies CMS wants to test could have reverberating effects among all insurers and bring consistency to the current haphazard state of home infusion reimbursement. 

Any benefit from such potential changes would come on top of various positive underlying factors: (1) a growing Medicare population; (2) expansion of insurance coverage; (3) the need for insurers and/or PBMs to have sufficient pharmacy networks that offer specialty and home infusion drugs; (4) an increased emphasis on cost-effective strategies, especially those designed to keep people in the home; and (5) the fact that many infused therapies lack treatment alternatives for chronic conditions like immunodeficiencies, autoimmune disorders, and hematologic disorders.  These factors have led to some consolidation among this fragmented industry over the years [e.g. Walgreen's purchase of Express Script's CuraScript and Omnicare's Option Care; Express Script's merger with Medco and its Accredo unit; CVS's purchase of Coram from privately-held Apria; BioScript's buying spree of CarePoint, HomeChoice Partners, and InfuScience; and Diplomat's purchase of privately-held MedPro Rx.]

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Advocacy in August Tips for Success: Schedule a Face-to-Face Meeting with Your Members of Congress

Scheduling a meeting with your elected officials is one of the best ways to be a home health advocate, while also building positive relationships with your lawmakers. Face-to-face meetings give you the opportunity to ask lawmakers to support for home care and hospice person, and from the perspective of the community that they represent.

Below are tips on how to set up a successful face-to-face meeting with your elected officials during the August recess:

  • Contact the local office of your Representative and Senators and
     ask to speak with the scheduler and/or the person who handles Medicare issues. It’s a good idea to speak with both.
  • Request a face-to-face meeting over the summer recess.
  • Organize other home care and hospice providers and advocates from
     the district/state to attend the meeting with you.
  • If unable to get a face-to-face meeting, you may do a “virtual
     meeting” by organizing a conference call with your Member of Congress
     and home care and hospice advocates in the district/state.
  • Review talking points, impact data, and the latest research on the value of home care and hospice and threat of proposed cuts and copays.
  • Urge your Members of Congress to contact Congressional leaders to
     oppose home health and hospice cuts and copays that would force Medicare
     beneficiaries into more costly hospital and nursing home settings.
  • Raise other issues that are of concern to your agency and the patients
     you serve. There is a range of important home care and hospice issues on the NAHC Legislative Action Network.
  • If your Members of Congress have taken a stand against home health and hospice cuts and copays, thank them for their support.

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Voting Open through September 30 for Top Home Care & Hospice Nurse of the Year

The National Association for Home Care & Hospice (NAHC) and its affiliate Home Healthcare Nurses Association (HHNA) recently announced the top 10 finalists for Home Care & Hospice Nurse of the Year. Now NAHC and HHNA invite their members, affiliated state associations, and the general public to visit NAHC’s website and vote for this year’s winner. The 2014 Home Care & Hospice Nurse of the Year will be announced at the NAHC Annual Meeting & Exposition on October 19 - 22, 2014 at the Phoenix Convention Center in Phoenix, Arizona.
When the meeting convenes, the top nurse and nine final contenders will come before NAHC members and get the recognition they deserve. “It is most appropriate that we make the effort to identify and celebrate the best among us, the nurses who distinguish themselves by the size of their hearts, by their professionalism, and by their work ethic,” said Andrea L. Devoti, RN, chairman of the NAHC board of directors. “Our focus is to highlight the impact that nurses make day in and day out in homes across the country, despite the challenges they face,” she explained. “And it’s time for the public to honor nurses and thank them for all they contribute,” added Elaine D. Stephens, RN, NAHC executive Vice President and current chairman of HHNA. “This is our chance to remind everyone how hard it is for nurses to do their vital work while facing senseless cuts in reimbursement.”

An expert committee chose 50 state winners, and narrowed them down to 10 top contenders, based on an essay about each nurse and thoughtful evaluation of their credentials. These 50 state nurses are featured in CARING online and will be invited to the NAHC Annual Meeting. Their registration fees will be waived, and they will be honored at a reception. The top 10 contenders will receive a $70 gift certificate from Hopkins Medical Products, now marking 70 years in business. The one who is chosen Home Care & Hospice Nurse of the Year will have their travel and hotel expenses paid, and receive a new Apple iPad along with a $140 gift certificate from Hopkins Medical Products.

The winner will also serve as a symbol of what nurses can do, and we need you to help pick this special nurse. To view the top 10 honorees, click here. Cast your vote for one of these 10 nurses who inspire us by their commitment to patients and love for their work.

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