Home Health & Hospice Week

A combination of proteins in the cerebrospinal fluid could help single out which patients with dementia will go on to develop full-blown Alzheimer's disease.

The results of a major international study conducted by a research team at the University of Gothenburg, Sweden, confirmed early studies that hinted at this link, according to a recent press release.

While there is currently no medication that can change the course of Alzheimer's, it's likely that medicines under development will have the biggest impact if they are used early on, said Dr. Niklas Mattsson of the Institute of Neuroscience and Physiology at the University of Gothenburg's Sahlgrenska Academy.

Changes in the brain are reflected in the cerebrospinal fluid (CSF) in the form of biomarkers, researchers found. Previous smaller studies have shown that finding the proteins beta-amyloid, tau, and phosphorylated tau in the CSF can be used to make an early diagnosis of Alzheimer's. The University of Gothenburg's larger study confirms these findings.

• Look for major changes in outcome measures. Once agencies begin using the OASIS C data set, outcome reports and Home Health Compare will necessarily change, the Centers for Medicare & Medicaid Services confirms. Some of the OASIS measures will be the same, some will be deleted, and others will be added, CMS said in a question and answer reported by the National Association for Home Care & Hospice. The change in items between OASIS B-1 and OASIS C means CMS will need to produce new reports based on data from OASIS C, once enough is available, the agency said.

New way: CMS plans to use three sets of reports under OASIS C.

1. Process measure reports -- which do not require risk adjustment -- will present measures based on the new process of care items on OASIS C. The first CASPER reports presenting  data on all the process measures will be based on the data from January 2010 through June 2010.

2. Risk-adjusted outcomes reports will present outcome measures based on the OASIS C items and will be risk adjusted using new models developed using the OASIS C items. The first preview report of risk-adjusted OASIS C outcomes will be based on data from January 2010 through December 2010.

3. Potentially avoidable events reports  (formerly adverse events) will present data onadverse events based on OASIS C. CMS has not yet decided whether to develop risk-adjustment models for these measures.

Heads up: Look for descriptions of the revised quality measures and drafts of the revised report formats on CMS' Web site by the end of September, the agency announced in its answer.

• The HHS Office of Inspector General has released its Work Plan for fiscal year 2010 and home health agencies are the subjects of numerous investigations. Among the topics the OIG plans to focus on are:

􀁘 Part B payments for services and medical supplies provided to beneficiaries in home health episodes.

􀁘 Accuracy of coding on claims, focusing on home health resource groups and documentation.

􀁘 Outlier payments for high rates of home health visits for insulin injections.

􀁘 Compliance with various aspects of home health prospective payment system billings, including location where services are provided and number of visits provided.

Resources: You can read the Work Plan at http://oig.hhs.gov/08/Work_Plan_FY_2010.pdf.

• You can now get answers to the questions asked prior to and during the Ask The Contractor teleconference held on Sept. 17.

On the Cahaba Web site, select "FAQ" to access the Frequently Asked Questions page. Then, under the "HH+H" listing, select the "Ask-The- Contractor Teleconferences" option.

• The Centers for Medicare & Medicaid

Services wants your feedback on Fee-For-Service policy and operational issues.

CMS is holding a Medicare Provider Feedback Town Hall Meeting on Oct. 29 from 2 p.m. to 4 p.m. Agenda topics include 5010, ICD-10, Medicare Contracting Reform, Recovery Audit Contractors, provider communications, and program intensity.

You must register in advance for the meeting before Oct. 23 at http://registration.intercall.com/go/cms2. Agenda and discussion materials will be available at www.cms.hhs.gov/center/provider.aspby October 23, 2009.