Welcome to the HealthPRO Heritage Blog

Seems as though CMS has taken a page out of Dorothy’s book with the mantra, “there’s no place like home.”  And those of us who have been in healthcare for any extended period of time can say, “We aren’t in Kansas anymore!” 

Nowadays, dozens of companies offer to set up therapy services within Senior Living communities. In most of these arrangements, the therapy company reimburses the Senior Living community for the gym space (via a lease agreement) and bills residents’ insurances directly for the therapy services they provide. Residents benefit because they have convenient access to rehab services. Therapy companies benefit by generating revenue via a robust caseload of patients.

But what’s in it for the Senior Living communities?

Value-Based Purchasing (VBP) will go into effect on January 1, 2023. The model incentivizes quality of care improvements while ensuring there is no limitation in coverage for Medicare beneficiaries and includes updated payment rates and reimbursement to Home Health Agencies (HHAs).

October 22, 2021 – HealthPRO Pediatrics is proud to announce that its Director of Staff Development Rebecca (Becky) Crouch, OTR/L was awarded the “2021 Fieldwork Educator Award” by the Occupational Therapy Association of California (OTAC) at their annual conference last night.

On Monday, October 18, 2021, the Secretary of Health and Human Services, Xavier Becerra, renewed the Public Health Emergency declaration, which includes access to waiver or modification of requirements under Section 1135 of the Social Security Act, for another 90 days. The new expiration date is set for January 16, 2022. Should the PHE end prior to the expiration date, a 60-day notice will be required.

Seems as though CMS has taken a page out of Dorothy’s book with the mantra, “there’s no place like home.” For those of us who have been in healthcare for an extended period of time, we can say, “We aren’t in Kansas anymore!” 

These past two years have been exceedingly eye opening for the medical world and the home health sector in particular as we are clearly still involved in a public health emergency. The COVID-19 pandemic escalated the importance of home health care as a needed and valued alternative to institutional and facility based care settings. In addition, as Valued Based Purchasing (VBP) will come onto the scene in early 2022, many agencies have had to shift the way they admit and care for higher acuity patients in a more efficient, cost effective, and responsive manner. 

Recent functional impairment data and staffing intel presented at the National Association of Home Care and Hospice (NAHC) Financial Managers Conference (FMC) surrounding visit utilization highlights the enhanced need to implement strategic scheduling. PDGM set out the initiative to reimburse agencies based on patient acuity and left it to providers to determine the appropriate level of care.

It’s been almost two years since the implementation of PDPM. However, since 2020 was so fraught with challenges from the COVID pandemic, almost no one had the opportunity to take stock of how they had fared last October, at the one-year mark. As we approach the second anniversary of the greatest change in Medicare reimbursement in more than 20 years, the industry is pausing to see how things have gone.

On the heels of several states announcing vaccine requirements, President Biden and CMS followed suit with an announcement on August 18 requiring that all U.S. nursing home staff be vaccinated. HealthPRO Heritage, along with many other healthcare associations, is advocating for equal treatment regarding vaccine requirements across care settings, rather than isolating to nursing home employees. The specific regulatory implementation guidelines are not yet fully developed and aspects of the mandate may change over the next several weeks.