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Home Health & Hospice Week

Industry Notes:

HOME CARE COULD PLAY ROLE IN HIGH COST DEMO

Published on Tue Jun 21, 2005

Goal: Reduced ER visits & hospital stays.

Although none of the six organizations chosen to participate in Medicare's three-year demonstration, Care Management for High Cost Beneficiaries, are home care providers, home care still can play a role in the demo.

The Centers for Medicare & Medicaid Services chose ACCENT, Care Level Management, Massachusetts General Hospital and Massachusetts General Physicians Organization, Montefiore Medical Center, RMS DM LLC, and Texas Senior Trails as participants.

The organizations will receive a monthly fee for each Medicare beneficiary involved in the demonstration to cover administrative and care management costs. But organizations must "assume financial risk if they do not meet established performance standards for achieving savings to Medicare," CMS says.

Beneficiary enrollment in the program will begin in fall 2005. CMS hopes the demo will promote evidence-based care, reduce unnecessary emergency room visits and hospital stays, and help patients avoid complications. The various models participants use will include support programs for health care coordination, self-care and caregiver support, physician and nursing home visits, use of in-home monitoring devices and 24-hour nurse telephone lines, education, outreach, tracking and reminders of patients' preventative care needs, and behavioral health care management. 

  • Several dozen U.S. senators have joined their House colleagues in calling for changes to Medicare's wheelchair policy. Thirty-four senators, including seven members of the powerful Senate Finance Committee, signed a letter asking Health & Human Services Secretary Michael Leavitt to change a Medicare policy preventing coverage of mobility devices for use outside the patient's home. Sens. Jeff Bingaman (D-MN) and Rick Santorum (R-PA) initiated the July 13 letter.

    Earlier this year, 61 House members signed a similar letter. To view copies of those letters, visit www.itemcoalition.org.
     
  • The medical equipment industry could soon find itself grappling with new medical device regulation.

    The Institute of Medicine on July 18 released a report charging that the Food & Drug Administration lacks an effective system for monitoring medical-device safety. The panel is urging the FDA to improve its tracking of studies conducted by device manufacturers after the products are on the market and to work with the private sector to improve device tracking.

    For a copy of the study, visit     www.iom.edu.
     
  • CMS recently announced a couple of new drug codes. New codes took effect this month for iloprost inhalation solution and high osmolar contrast material under the Healthcare Common Procedure Coding System.
     
    For details, see the MedLearn Matters article on the CMS Web site at     www.cms.hhs.gov/medlearn/matters/mmarticles/2005/MM3847.pdf.
     
  • Home care company valuations are on the rise, says Pittsburgh, PA-based mergers and acquisition company The Braff Group. A successful initial public offering in June by regional home care chain LHC Group of Louisiana shows that investors are well disposed to home care.
     
    "Such an enthusiastic market response bodes extremely well for both buyers and sellers alike," according to the June issue of the Braff Report.
     
  • Arcadia Resources Inc. is building on its Florida operations. The Southfield, MI-based home care, durable medical equipment, pharmacy and staffing company has acquired the Fort Myers, FL, operations of Alternative Home Health Care of Lee County Inc., which provides licensed nurses, certified home health aides and support services in Florida's lower western Gulf coast region. Alternative will retain ownership and operations of its office located in Fort Lauderdale, FL, Arcadia says in a release.

    The acquisition will take on the Arcadia name and will offer home care and DME, including oxygen and respiratory services. Arcadia purchased DME supplier United Health Care Services with locations in Fort Myers and Port Charlotte, FL, earlier this year (see Eli's HCW, Vol. XIV, No. 15).
     
  • Rotech Healthcare has finally released its first-quarter results, and the news is not good. The Orlando, FL-based respiratory supplier reported a net loss of $3 million for the period on revenues of $123.3 million. That compares to earnings of $9.1 million on revenues of $133 million in the same period last year.

    The company plans to continue "re-establishing growth and refocusing the company's culture toward patient care," says President and CEO Philip Carter.
     
  • Another hospital is shedding its home care program, and the community isn't happy about it. Greenwich Hospital in Greenwich, CT, began transitioning its patients to other agencies in June, reports the Greenwich Time. The agency lost up to $1.4 million last year, the hospital said.

    Multiple letters to the newspaper's editor have protested the closing. The hospital is "failing in its social responsibilities to all members of the community," one Greenwich resident wrote.
     
  • Tennessee's Home Health Care Administrator of the Year in 2002 has plead guilty to federal fraud charges, the Associated Press reports. U.S. De-partment of Justice prosecutors last year accused owner Charles Madison Warren III of claiming costs from his Clarksville, TN-based private duty nursing company Health Professional Services Inc. in the cost reports for his Medicare-certified Complete Home Health Care Inc.

    Warren is scheduled for sentencing in October, AP says.

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