The Alliance for Home Health Quality and Innovation (the Alliance) http://ahhqi.org on June 30, 2016 conducted a panel discussion on the White Paper published in 2014 developed for the “Future of Home Health Care (FOHH)” Project. The final report is scheduled to be released later in 2016. The Alliance partnered with Avalere Health http://avalere.com to research and develop a vision for the future of home healthcare.
In three years, according to a report from the United Nations, people over the age of 65 will outnumber those under age five and increasing numbers of seniors will face significant functional impairments.
Medicare www.cms.gov and other payers that are will increasingly turn towards Alternative Payment Models (APM) will need to make a strategic shift to making care in the home and community a priority.
The FOHH Project Framework describes four key characteristics for the Medicare home health agency of the future:
- Provide post-acute care and coordination by forming partnerships with hospitals, staff, physicians, and caregivers
- Partner with longitudinal outpatient primary care medical homes and homebased primary care programs
- Partner with home-based long term care and social support models
However, in order to achieve the goals discussed in the Framework, CMS will need to allow the payment system to reimburse for services that are essential for integrating patient care. This may include health IT capabilities, telehealth, and staffing for care coordination and care transition support.
Also recommended, CMS should address financing and regulatory constraints that are barriers to the use of clinically appropriate and cost effective home health care to meet APM goals. This includes testing of the selective waiver of the current requirement that a beneficiary be homebound to receive the Medicare home health benefit.
The Framework calls for targeted reforms in the home healthcare community to combat fraud and abuse through program integrity measures that focus on the well-known “hot spot” areas identified through aberrant claims patterns.
Go to www.ahhqi.org/images/pdf/future-whitepaper.pdf to view the White Paper published in 2014.