Home Health & Hospice Week

CMS to start knocking on doors to recruit.

A demonstration project that could result in more referrals to home care is looking for volunteers--but there's a catch.

The Centers for Medicare & Medicaid Services is testing patient assessment, outcomes and payment across the post-acute spectrum--home health agencies, skilled nursing facilities, inpatient rehab facilities and long-term care hospitals. CMS has pilot tested the Continuity Assessment Record and Evaluation (CARE) tool in those providers already (see Eli's HCW, Vol. XVI, No. 27).

Now CMS wants to conduct a full-fledged demonstration in early 2008, and the agency needs volunteers. But the 26-page assessment tool will be a major added burden to HHAs, experts fear.

CMS appears to recognize that it will have a hard sell with the demonstration. "Providers may ... be targeted for recruitment from analysis of Medicare administrative files and will be contacted," CMS says in a release about the project.

The agency and its contractor, RTI, plan to conduct the demo in 10 "distinct" areas of the country. CMS and RTI will consider characteristics such as corporate ownership, profit status and size for participants.

Hidden bonus: Although the demo will be a paperwork burden for participants, it may end up benefiting the industry in the long run. "A key goal of this project is to generate recommendations for improving CMS payment models," CMS says in the release. Reform includes "aligning incentives among the four PAC settings."

In other words, if home care can provide the same patient outcomes for much less cost than the other inpatient post-acute providers, CMS may encourage more patients to utilize home care. That would bring more patients and more Medicare dollars to agencies. • Just because Congress is officially on recess doesn't mean there's not lots to do to head off looming payment cuts to home care providers.

The Bush Administration and Congress have continued to wrangle over the State Children's Health Insurance Program (SCHIP) this month, with President Bush again threatening a veto of Congress' legislation reauthorizing and expanding SCHIP. The House's SCHIP bill also calls for a Medicare payment rate freeze for HHAs in 2008, a reinstatement of the 5 percent rural add-on, oxygen payment cuts and elimination of the first-month purchase option for power wheelchairs.

Democrats have launched radio and phone campaigns criticizing Republicans' votes on the SCHIP bill and the Bush Administration has set new requirements for SCHIP expansion that has left states fuming.

The National Association for Home Care & Hospice and the Visiting Nurse Associations of America is fighting back with a joint letter to congressional heads decrying the HHA cuts included in the House bill. If CMS implements the rate freeze and payment cut for supposed case mix creep, "more than 46 percent of home health agencies will [...]