Many home health providers also offer hospice care, but tangled rules sometimes prevent patients from receiving these services at the same time. This has led to some changes at the national level, such a Medicare program to allow simultaneous hospice and curative care. At the state level, a leader at one agency in Mississippi took matters into his own hands and successfully advocated for a Medicaid rule change that could extend care to 18,000 people.
After a combined effort between Medicaid and Gentiva Health Services, an affiliate of Kindred at Home, that started over 18 months ago, eligible patients in Mississippi will be able to receive home and community-based services (“waiver services’) at the same time as hospice services.
Typically, Medicaid waiver services provide adult day residential care, home-delivered meals (Meals on Wheels), personal care services, institutional respite services, in-home respite and expanded home health visits, a Kindred at Home press release states. Aside from providing spiritual and emotional support and personal care to patients and their family members, hospice services usually include skilled nursing care under supervision of a doctor or services that are not covered under the waiver program.
The change to the state’s Medicaid rule comes after Danny Mullins, Mississippi-area vice president of sales at Gentiva Health Services, took a closer look at how the rules were affecting patients and the money being spent to keep patients in higher-care environments.
The original rule aimed to reduce costs and keep those with terminal illnesses out of more expensive care settings like nursing homes, but it was actually doing the opposite.
“The old program was unintentionally keeping patents away from hospice care,” Mullins tells Home Health Care News. “Patients would be forced to choose between their waiver services, like Meals on Wheels, or hospice care.”
On the financial side of things, the old program kept Gentiva’s referrals down because few patients wanted to give up their services for hospice care. This forced patients into care that was more expensive than hospice and ended up costing Medicaid more money, Mullins explains.
Prior to the change in the rules in June 2016, there were some 18,000 Mississippi residents who had to choose between one set of services or another, according to the press release. Now, in most cases, they won’t have to choose.
There is one catch with the new rules in Mississippi, though—patients using waiver services and hospice services at the same time won’t be able to have care from both programs in their homes on the same day. But, if hospice comes on Tuesdays and a home health aide comes on Wednesdays, it will be allowed.
“These changes will save Medicaid dollars, help patients remain home—where they want to be—help the hospitals and help the physicians caring for the patients,” Mullins said in the press release.
Written by Alana Stramowski