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August 22, 2024 | ||||||||||||||||||||||||||||||
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![]() This Week at CT Healthcare At Home
News Update
Source: NAHC-NHPCO Alliance, August 8, 2024
Home Health
CMS announced a transition for the home health grouper software.
The current version of Home Health (HH) Grouper uses Java software and is currently based on Java version 8. Support for Java version 8 will end by November 2026. Home health agencies and their software vendors who implement the HH Grouper in a mainframe environment will be impacted by this change. CMS is preparing now to convert the programs to Java version 17.
For the upcoming year, the October 2024 update and subsequent quarterly releases of the HH Grouper will include two Common Business-Oriented Language (COBOL) Java bridge modules instead of the one that is currently delivered. CMS will continue to provide the existing bridge module that utilizes the 31-bit, Java 8 Java Virtual Machine (JVM) environment. CMS will also provide a new bridge module that will utilize the 64-bit, Java 17 JVM. The Java jar file for each will continue to be compiled using Java 8. This will preserve backwards compatibility with all existing mainframe deployments (both batch and Customer Information Control System (CICS). The installation guides for the program will provide notice of the changes. This will allow users to test upgrades to their systems over the next year to prepare to move to Java 17.
Segment on Hospice
Source: NAHC-NHPCO Alliance, August 19, 2024
Last night, Sunday, August 18, the HBO and Max current events satire show, “Last Week Tonight with John Oliver” aired a segment on hospice. The show pointed out some of the positives of hospice care, while also underscoring concerns about fraud and hospice program integrity that the NAHC-NHPCO Alliance and its predecessor organizations have been working on for years. On the other hand, the crude nature of the humor, combined with a focus on old stories about fraud and, eligibility for care, and marketing practices, has the potential to be confusing for some viewers. The Alliance understands that different people in our hospice community will have different perspectives on the segment. Some worked hard to make it happen, and may even feel good about it, or about pieces of it. Unfortunately, viewers tend not to recall details of a story like this, so the narrative that most people are likely to take away from it is that hospice may be something to be concerned about.
To help Alliance members engage productively with their communities – including patients, families, referral sources, community partners, and media – we have put together a document to support conversations with anyone who sees the segment and asks stories.
We have also published a statement for media, which you can find on the legacy NAHC website and the legacy NHPCO website.
Source: Home Health Care News, August 6, 2024
Pediatric home health care is a tough business to be in, but it’s also one filled with opportunity if providers can find operating models that work.
The U.S. pediatric home health care market was estimated to be valued at $12.53 billion in 2023. It is expected to grow at a compound annual growth rate of 7.85% from 2024 to 2030, according to a report from Grand View Research.
Growth in this industry can be attributed to several factors. These include the rise in chronic diseases, increased demand for home health services for infants, technological advancements, higher health care spending, adoption of smart home health care models and more insurance and legislative support.
“The pediatric home care space really is not that old,” Mark Kulik, senior managing director of home health, home care and hospice for the Braff Group, told Home Health Care News. “About 25 to 30 years ago or so is when the concept of taking a medically fragile child home and out of the hospital really began.”
The Braff Group, based in Pittsburgh, is an M&A advisory firm that specializes in health care services.
Source: McKnights Home Care, August 9, 2024
Medicare Advantage plans are denying an increasingly large share of prior authorization requests, limiting beneficiaries’ access to services like home health and dialysis, according to new reports by KFF.
KFF examined Medicare Advantage contract data for 2022, which is the year with the most recent available figures. KFF’s analysis found that MA plans denied 3.4 million prior authorization requests that year, which is about 7.4% of the 46.2 million requests submitted in total by beneficiaries. This was a higher share of denials than the three previous years; MA plans denied slightly less than 6% of prior authorization requests each year between 2019 and 2021.
Home health is among the top healthcare services for which MA insurers request prior authorization. Roughly 90% of MA enrollees who requested home healthcare in 2024 were required to receive prior authorization, according to KFF. About two-thirds of beneficiaries requesting dialysis, and 46% of those seeking transportation services, were also required to receive prior authorization.
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![]() CMS Unveils Services Available to Patients in the GUIDE Model, Integrates Palliative Care Principles
Source: Hospice News, August 12, 2024
The U.S. Centers for Medicare & Medicaid Services (CMS) has outlined the range of services that will be available to patients aligned with the agency’s Guiding an Improved Dementia Experience (GUIDE) payment model.
The payment model is designed to improve quality of life for dementia patients and their caregivers by addressing care coordination, behavioral health and functional needs. While the model does not use the term “palliative care,” it does incorporate principles and practices traditionally associated with those services, such as interdisciplinary care and caregiver support, among others.
Source: McKnights Home Care, August 12, 2024
It’s no secret that most seniors want to age in place, but there is an often-overlooked obstacle in the way. And it’s a big, green, grassy one. As many homeowners get older, the lush lawns they brag to their neighbors about become harder and harder to maintain. Ken Kohlmann, vice president of Yarbo, witnessed this firsthand and sought to find a solution.
“Two of my uncles passed from Parkinson’s,” Kohlmann told McKnight’s Home Care Daily Pulse. “Through that, they lost their independence and they could do less and less, but the lawn still had to be cut; you still have to remove snow from the driveway. Our CEO [of Yarbo] had a couple friends who actually passed away from heart attacks [while] doing snow removal and so we really wanted to come up with a product that could help people.”
Source: McKnights Home Care, August 8, 2024
In an aging society, family caregivers often shoulder the immense responsibility of caring for older loved ones while rearing children and working full-time. Unfortunately, juggling all of these duties can lead to significant emotional, physical and financial strain. As the population of older adults continues to grow, the demand for caregiving is outpacing the availability of human caregivers and creating a pressing need for innovative solutions. Artificial intelligence (AI) can be a powerful ally that offers ways to mitigate the burden on family caregivers and bridge the gap in the caregiving workforce.
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