Home Health & Hospice Week
JOINT REPLACEMENT PATIENTS FARE BETTER AT HOME, STUDY SAYS
Finding: Home care costs Medicare less for these patients.
A new study commissioned by the Medicare Payment Advisory Commission could give a boost to home care for lucrative hip and knee replacement patients.
According to a study conducted by RAND Corp., patients discharged to skilled nursing or inpatient rehab facilities were more likely to be reinstitutionalized within 120 days after acute care discharge when compared to patients discharged to home care.
Mortality rates were the same for the groups, RAND researcher Melinda Beeuwkes Buntin told MedPAC at its April 21 meeting.
In addition, SNF and IRF care cost significantly more than home care - an average of $3,500 more for SNFs and $8,000 more for IRFs, RAND found.
MedPAC also conducted a panel study of 11 physicians specializing in joint replacement. The physicians recommended that patients recuperate at home instead of in an IRF or SNF unless extenuating conditions called for facility care, reported MedPAC staffer Sally Kaplan.
Because of changes to IRFs' 75 percent rule governing Medicare payment, more joint replacement patients are going to other post-acute settings for post-operative rehab, Kaplan noted.
More information on the study findings, which will be included in MedPAC's June report to Congress, is at www.medpac.gov/public_meetings/transcripts/0405_transcript_full.pdf (starting on p. 201).
Bidding contractor Research Triangle Institute of Research Triangle Park, NC. will be holding four focus groups with suppliers to assess the potential impact bidding will have on their businesses.
The sessions will be held in Dallas on May 4 and Chicago on May 5. CMS held its first focus groups with suppliers earlier this month at the Medtrade show in Las Vegas.
More details on the focus groups are at www.cms.hhs.gov/suppliers/DMEPOS.
When the agency announced it was proposing new coverage criteria in February, it expected to publish the criteria by the end of March. At press time, the coverage determination still had not been published. At the April 21 Open Door Forum, Eric Sokol of the Power Mobility Coalition asked when suppliers might see the NCD.
"I can't say that, because it's a complicated issue no matter how you look at it," a CMS official responded. "It is still in the clearance process."
The state is failing to comply with a law requiring annual updates of home health rates, the Association says in a release. New Hampshire hasn't updated rates since 1999, according to the trade group.
Some visiting nurse associations already have discontinued Medicaid homemaker programs due to losses, HCANH says. The association has requested an expedited hearing from the state court.
"This filing represents the Association's last course of action," Susan Young, HCANH executive director, says in the release.
Region B DMERC AdminaStar Federal notes that providers are not using the KX modifier when billing for CPAP equipment and accessories that have met coverage criteria. The DMERC reminds providers that use of the KX modifier became effective July 1, 2002.
On claims for the first through third months, suppliers must add a KX modifier to codes for equipment (E0601) and accessories only if all of the criteria in the "Indications and Limitations of Coverage and/or Medical Necessity" section of this policy have been met, AdminaStar instructs. If the requirements for the KX modifier are not met, the supplier may submit additional documentation with the claim to justify coverage, but the KX modifier must not be used.
After announcing plans to purchase Interim Healthcare of Wyoming (see Eli's HCW, Vol. XIV, No. 15), the Pittsburgh-based company says it has "several negotiations in process simultaneously with other [home health] agencies ... and we expect to make announcements on their progress in the very near future." The company's speech technology - a talking pill bottle, transcription service, forms and speech medical recognition products - "can make a significant impact on the bottom line of these ... agencies," Wizzard CEO Chris Spencer insists in a release.
Rather than waiting for HHAs to invest in speech technology themselves, the company is "moving forward to overhaul several of these agencies using speech technology and demonstrate to the industry its benefits." At the same time, Wizzard will enjoy the HHAs' "substantial profitability."
ResCare also has completed its purchase of certain assets of St. Joseph Home Care from a subsidiary of St. Joseph Hospital in Augusta, GA. Res-Care expects revenues for the personal care and companion service unit to be $1 million annually.
"We have many opportunities around the country, and it was just our decision that there were other cities where we should put our resources," Jenny Haynes, Odyssey VP of investor relations and corporate communications, told the paper.
Home Health & Hospice Week
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Log those orders to comply with deadlines.
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JOINT REPLACEMENT PATIENTS FARE BETTER AT HOME, STUDY SAYS
Finding: Home care costs Medicare less for these patients.
A new study commissioned by the Medicare [...]
