In The News

RAISE Act Council Offers National Caregiver Support Strategy 

A 102-page report marks the RAISE Act Family Caregiving Advisory Council’s September completion of the first-of-its-kind National Strategy to Support Family Caregivers. The product of extensive deliberation and analysis of expert contributions, the report includes substantial background information on the current landscape of family caregiving, as well as many proposed federal, state and local actions in support of caregivers. The proposals are organized under five major goals: 

  • Improved awareness of and outreach to family caregivers; 
  • Inclusion of family caregivers in the care team; 
  • Services and supports for family caregivers; 
  • Financial and employment protections; and 
  • Data, research, and best practices.  

The ACL website provides access to the entire document and supporting materials. Comments from the public are encouraged through the deadline of November 30. 

Publication of the national strategy has been met by enthusiastic reactions across the caregiving spectrum, including the Family Caregiver Alliance (FCA). “We share the authors’ hope,” FCA stated, “that as the Strategy is implemented—and as the nation more fully comes to understand and respond to the challenges faced by family caregivers—society will embrace the cultural and policy shifts necessary to support them. As a result, over time, lawmakers likely will be called upon to propose legislative changes to better support family caregivers. This is a historic moment for family caregiving because, as the Strategy introduction states, ‘This is the first time that ideas from local and state agencies and nonprofit organizations are integrated with recommendations for the federal government in a combined initiative dedicated to family caregiving. The development of these lists also represents the first time that agencies across the federal government have formally worked together to coordinate family caregiver support planning.’”

 

Final Rule ‘Blunts Immediate Impact,’ But CMS-Home Health Industry Core Disagreement Remains

Home Health Care News | By Joyce Famakinwa
 
Nearly five months after the unveiling of the proposed payment rule caused a stir among home health stakeholders and advocates, the U.S. Centers for Medicare & Medicaid Services (CMS) released its final payment rule on Monday.
 
Back in June, CMS proposed a 4.2% aggregate decrease for 2023, a cut the industry at large felt would be devastating.
 
Though CMS will still usher in other cuts and permanent adjustments related to the rebalancing of the Patient-Driven Groupings Model (PDGM), the final rule comes with an increase in the aggregate by 0.7%, or $125 million compared to 2022.
 
While many in the industry acknowledge that CMS has made efforts to address the concerns of providers, most are still stressing that the methodologies CMS is following will eventually crush providers and access to care .
 
“CMS has rightly recognized the challenging operating environment providers are currently navigating and reduced payment cuts from the 7.69% proposed in June to the 4% announced today,” LeadingAge President and CEO Katie Smith Sloan, president and CEO said in a statement. “That, along with the 4% market basket update that addresses rising costs of providing services, indicate CMS is cognizant of current realities. We appreciate that — but at the same time, we remain concerned.”
 
CMS also decided to take a phased-in approach to the behavioral adjustment and only impose about a 3.5% adjustment for a 30-day period. This is an overall $635 million decrease in reimbursement for agencies.
 
“Agencies need to understand that this is only ½ of what will be imposed after this year,” J’non Griffin, senior vice principal of coding and the OASIS department at SimiTree, told Home Health Care News in an email. “The remaining permanent adjustment, along with any other potential adjustments needed to the base payment rate to account for behavior change based on data analysis, which are all required by law, will be proposed in future rulemaking.”
 
In the wake of the proposed payment rules release, many took aim at the behavioral adjustment methodology CMS used. With the final rule out, it is still viewed as problematic.

[The HH PPS Final Rule is available at https://public-inspection.federalregister.gov/2022-23722.pdf]

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Calendar Year (CY) 2023 Medicare Physician Fee Schedule Released

The Centers for Medicare & Medicaid Services (CMS) has finalized changes in CMS’s annual Physician Fee Schedule (PFS) proposed rule to significantly expand access to behavioral health services and moves the health system closer to achieving equitable outcomes through high quality, affordable, person-centered care. These changes will ensure CMS continues to deliver on our goals of advancing health equity, driving accountable care, and protecting the sustainability of the Medicare program.

Building on the CMS Innovation Center’s successful ACO Investment Model (AIM), CMS is changing the Medicare Shared Savings Program to make more Accountable Care Organizations (ACOs) available in rural and underserved areas, which builds upon our continuing efforts to advance health equity. We are launching a payment adjustment for ACOs that reward them when they provide excellent care to underserved populations.

The Innovation Center also sought comment on an alternative approach to calculating ACO historical benchmarks that would use administratively set benchmarks that are decoupled from ongoing observed FFS spending including the design of the approach, as described in the Request for Information (RFI). CMS has observed that the benchmarking methodology for the Shared Savings Program and Innovation Center models may include ratchet effects that reduce benchmarks for successful ACOs and jeopardize their continued participation over multiple agreement periods, resulting in selective participation (including limited participation by inefficient ACOs). The RFI gathered information regarding the future use of administrative benchmarking, and comments will be considered for future rulemaking.

For more information, please see the PFS press release.

 

APTA Nominations and Awards Program Open

The nominations call for the Honors and Awards program is open from September 1- December 1. Nominations must be submitted through our online portal by December 1; late submissions will not be considered. Selected recipients and their nominators will be notified in May.

The APTA Honors & Awards program recognizes outstanding achievements by members in the areas of overall accomplishment, education, practice and service, publications, research, and academic excellence. Information about eligibility and the nominations process is included in the individual descriptions that can be found at  https://www.apta.org/apta-and-you/honors-awards

Resources

 

COVID, Flu, & RSV

Cases of COVID, the flu, and respiratory syncytial virus (RSV) are expected to rise this winter, potentially creating a ‘tripledemic.’ Scientists say the pandemic ‘immunity gap’ is probably behind the surge in viruses. Experts advise Americans to get vaccinated against COVID and the flu to prevent their local hospitals from overflowing. RSV vaccines are currently in development and Pfizer has begun studying a combination vaccine for COVID and the flu.

  • COVID-19: Coronavirus-related hospitalizations are rising and at least half a dozen Omicron subvariants are competing to be the next dominant strain in the US. New data from Pfizer suggests that the updated booster provides four times stronger protection against more recent Omicron variants than the original vaccine. 
  • The Flu: So far, this flu season has been earlier and more severe than it has been in 13 years, according to data from the Centers for Disease Control and Prevention (CDC). Inequities have been found in flu vaccine uptake. Black, Hispanic, and Indigenous adults are more likely to be hospitalized with the flu and less likely to be vaccinated against it.
  • RSV: RSV is a common respiratory virus that can be serious for young children and older adults. Children’s hospitals are being overwhelmed by the nationwide surge in RSV cases. The unusually early and drastic spike in RSV cases has increased wait times and is straining health care resources.
 
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