Covid-19 and Home Health Care Telehealth: The Big Shift

The home health care industry has long pioneered a mix of in-person and remote care services to provide continuous care to patients in their homes. In the past, however, the industry has not necessarily utilized the latest technologies. Until recently, “remote care” was primarily defined by phone calls.

Part of the issue has been the unequal balance of providers and a growing population of home care patients. Remote care is a potential benefit to care coordination, but many home healthcare agencies have lacked the staff to provide for both in-person and remote care.

Another issue exacerbates this imbalance. Traditionally, the health industry has been unable to bill insurance companies for remote care. Without an easy path to payment, home health agencies, many of which are privately-owned, cannot expend valuable time and resources on remote care.

The health care paradigm shifted earlier this year when the pandemic forced the closure of many services, and most of the American population was ordered to shelter in place. Suddenly, health systems small and large—from private home health care agencies to large hospitals—had to provide attentive care while minimizing exposure to the Covid-19, especially for at-risk patients, many of whom utilize in-home services.

Far from floundering, however, most health systems used the crisis to create a new opportunity. As Bailey Bryant, writing for Home Health Care News, recently noted: “The health care sector has long had the capability to use telehealth, but it took the COVID-19 emergency to prompt widespread adoption.”

Read: “Senior Telehealth Use Continues to Rise, Despite Home Health Limitations

The pandemic has changed people’s thinking about telehealth services, and caregivers are taking advantage of new technologies to provide seamless care.

Writing for mHealth Intelligence, the editor Erik Wicklund writes that home health care workers use: “telemedicine technology, ranging from mHealth apps and connected devices to remote patient monitoring and smart home programs, to provide a continuous care experience, and one that balances clinical support with self-management.”

Read: “The Promise and Potential for Telehealth in Home Health”

Indeed, after nearly a half year of utilizing telehealth services, both caregivers and patients alike are realizing the benefits of more seamless coordination between in-home and remote services.

Home Health Care Telehealth: Attention from Lawmakers

Lawmakers have started to recognize a need to improve billing for remote care services—though not yet for the home health care industry. As Bailey Bryant notes in her article about telehealth and home health care:

“The increased use of telehealth among the senior population is largely thanks to new Centers for Medicare & Medicaid Services (CMS) flexibilities allowing dozens of telemedicine services — though not yet home health — to be billed at the same rate as in-person visits.”

However, some lawmakers have recognized a need to reimburse private agencies, like home health care providers. For example, the senator Susan Collins, of Maine, has said she was working on a bill to reimburse home health care telehealth services (source).

“I plan to introduce a bill soon to create a framework to reimburse for telehealth services provided by home health agencies,” Collins said.

In the meantime, home health care agencies like Forever Young, which services patients in the greater Philadelphia area, including the surrounding suburban areas, continue to strive to match the standards of a pre-pandemic standard of care while working with an entirely new set of variables.

Federal Cuts to Home Health Funding May Be Coming

seniors-face-higher-costs-on-medicaid-cutsFederal Medicare cuts may be on their way if CMS (The Centers for Medicare and Medicaid Services) is able to “rebase” home health funding and cut other revenue within the system. These cuts may result in a 14% overall reduction to Medicare home health payments, causing negative Medicare margins in most U.S. States.

Seniors should be absolutely up in arms about these potential spending cuts as they may put small business operators out of service and greatly reduce the amount of home care services that are functioning in their community. This will greatly reduce choice, reliability, and quality in the services provided under the current home health funding system.

The government agency that oversees Medicare has proposed across-the-board cuts to home health care payments, which are today confronting the 3.5 million seniors who receive skilled home health care services each year.

On the heels of funding reductions totaling 22 per­cent since 2009, which amount to $72.5 billion over 10 years, Medicare home health payments are again on the chopping block.

The Centers for Medicare and Medic­aid Services, or CMS, is proposing to “rebase” home health funding at a rate set at the maximum level allowed by law, in addition to a host of other revenue cutting changes.

Analyses show these cuts will result in a 14 percent overall reduction to Medicare home health payments. Such drastic cuts will cause 47 out of 50 states, including Pennsylvania, to soon have negative Medicare margins.

In total, when coupled with cuts already underway, Medicare home health will experience $100 billion in cuts over 10 years.

Recently, Louisiana Sen. Mary Landrieu, acting as chairwoman of the Senate Committee on Small Business and Entrepreneurship, sent a letter to the CMS expressing concern for the proposed 14 percent cut to Medicare home health.

Similarly, a bipartisan group of 142 members of Congress recently sent a letter to CMS urging a more complete analysis of the proposed rule as well as its impact on beneficiaries and small businesses.

In September, the U.S. Small Business Administration expressed similar concerns in a letter to CMS that the proposed rule underestimates the impact the rebasing cuts will have on the nation’s small home health agencies.

Advocates for senior citizens including AARP as well as organizations representing physicians, nurses and veterans also have spoken out publicly about the impact of such deeps cuts on the nation’s vulnerable home health patient population.

The value of home health care to the Medicare program cannot be understated. As more seniors require care, we must be poised to provide the most clinically effective care in the most cost effective setting. As the Obama administration and Congress work toward improving health care delivery in America, home health care must be supported — not abated.

Reach out to your local representatives and let them know that cutting home health funding is not in your interests. Let them know that CMS needs to re-evaluate their position and analysis as it pertains to the of home care for seniors.

For more information about Home Health Care and Skilled Nursing contact us or call (267) 288-5496

Source: NOLA

About Time: New Fair Labor Rule Gives Home Care Workers Get Wage Protection

Home Health Aide Makes a Bed For A PatientWell its about time. We have always prided ourselves on paying our home care workers and home health aides (HHA) above market rates, but apparently greed gets in the way for other companies. So we are pleased to announce that the Obama administration will no longer allow that practice, making minimum wage laws apply to home care workers, like the rest of the work force.

Until this rule, home care workers were compared to babysitters, who do not fall under the Fair Wage and Standards Act’s minimum wage policies. This distinction comes at an important time with home care workers on the rise as seniors who need in-home assistance rise. In our opinion, the work our home health aides do is much harder and more labor intensive than a babysitter. We are happy this administration finally sees it our way and makes the distinction.

The Obama administration announced on Tuesday that it was extending minimum wage and overtime protections to the nation’s nearly two million home care workers.

Advocates for low-wage workers have pushed for this change, asserting that home care workers, who care for elderly and disabled Americans, were wrongly classified into the same “companionship services” category as baby sitters — a group that is exempt from minimum wage and overtime coverage. Under the new rule, home care aides, unlike baby sitters, would be covered under the Fair Labor Standards Act, the nation’s main wage and hour law.

In an unusual move, the administration said the new regulation would not take effect until Jan. 1, 2015, even though regulations often take effect 60 days after being issued. The delay until 2015 is to give families that use these attendants, as well as state Medicaid programs, time to prepare.

Sadly, the new regulation will not take effect until Jan 1, 2015. Which still gives these underpaying companies time to skirt under the law. But a change is coming, and we are happy to see it. 

For more information about becoming a Home Health Aide or to hire a Home Health Aide in the Philadelphia area, Bucks County, and/or Montgomery County, please contact Forever Young Home Health Care at info@foreveryoungPA.com or (267) 288-5496.

Source: New York Times

Source: Department of Labor