Home Health & Hospice Week

Some provisions are helping now, some will help later.

It’s not only the funding and tax provisions of the CARES Act that are helping home care providers survive COVID-19’s impact. Regulatory flexibilities — some temporary and some permanent — are boosting providers’ financial health.

“Revisions to the definition of homebound status during the period of the public health emergency, the allowance of nurse practitioners and physician assistants practicing in accordance with state laws to certify patient eligibility and provide orders for home health care services, and the ability to accept telehealth visits for purposes of the required face-to-face physician encounter” are benefitting home health, noted Encompass Health Corp. CEO Mark Tarr in the company’s April 29 earnings call for the first quarter of 2020.“These regulatory actions have given our … agencies the types of enhanced flexibility they need to care for our patients and assist acute care hospitals in maintaining hospital capacity in the current environment,” Tarr said.

The non-physician practitioner orders “provision is something the industry has sought for a number of years legislatively,” Amedisys Inc. CFO Scott Ginn observed in the company’s May 8 earnings call.“It creates immediate new referral sources in those states where there has been similar state regulatory relaxations or waivers tied to the public health emergency.”

And remember, the NPP orders change is permanent.“For the first time without regard to the emergency, nurse practitioners and physician assistants can order and follow a Home Health plan of care and conduct face-to-face business,” LHC CEO Keith Myers praised in the call.

Right now: “The biggest value we’ve seen is the ability to virtually have a presumptive homebound status,” Encompass Home Health and Hospice CEO April Anthony said in the call.“Obviously, in this environment, our high-risk seniors are advised to stay home. So the ability to document that homebound status and rely on the physician’s recommendation for them to be homebound has been helpful, probably again, more administratively than anything, but it’s certainly a help during the course of this PHE.”

In the future: “The biggest … long-term value for us is the ability for NPs and PAs to be able to sign orders prospectively,” Anthony judged.“That’s going to give us a much easier flow of communication when we have larger practices where they have NPs and PAs.And in our rural markets where many of the patients are being served primarily by those NPs and PAs, it’s going to open up a whole new avenue of referral source for us,” she said. While that change’s impact has been “relatively minimal” so far, “over time as that new provision stabilizes and is long term, that’s going to create opportunity for us in the future,” Anthony said.