Between a new demonstration project, two damning studies, a lawsuit and a proposed rule, it has been a week of highs and lows for the home care field. To make sense of all the news that unfolded over just four days (as of this writing, it’s only Thursday), here is a brief rundown of who came out on top and those who, sadly, did not.
People with disabilities: Nearly 50 years ago, Section 504 of the Rehabilitation Act of 1973 was signed into law. On Thursday, the Department of Health and Human Services proposed a rule to strengthen protections for people with disabilities against discrimination. Among the provisions, the proposed rule requires the distribution of services in the most integrated setting. It points out that many people with disabilities, due to inadequate services, have to go to nursing homes and other institutional settings. A push to keep people out of institutions? Sounds to me like a good day for people with disabilities.
Community-based care: This week also was positive for community-based settings, thanks to a new demonstration project unveiled by the Center for Medicare and Medicaid Innovation. The project aims to shift healthcare spending and utilization from acute care to primary care and community-based settings. The project even offers an opportunity to offer more home care, one expert said. I think the industry will agree with me when I say we’ll take it.
Home health clinical outcomes: Two studies this week revealed a dark side of home healthcare. One found that antipsychotics are overprescribed in home health settings. Another found that home healthcare agencies fail to report more than 55% of falls leading to serious injuries and hospitalizations. These studies come as the industry is clamoring for more funding. Probably not the best argument for more money.
Medicare Advantage: The private Medicare program did not have the best week as Humana filed a lawsuit against a final rule that likely will claw back billions in overpayments to MA. Clearly, the insurer is upset about the prospect of having to return so much money. But with insurers raking in zillions from MA, it’s hard to muster much sympathy for the firms. I’m guessing the U.S. District Court judge will feel the same way.
To those who had a good week, here’s to more sunny days ahead. For the rest of you, well, there’s always next week.
Liza Berger is editor of McKnight’s Home Care. Email her at [email protected].