During this critical time, Home Health Care News remains committed to bringing you all the essential news related to home-based care operations. At the same time, we also recognize the seriousness of the COVID-19 pandemic. In addition to our regular content, we’ll continue to highlight industry-related developments and mitigation strategies in this rolling bulletin.
What you need to know from Friday through Sunday (June 26-28):
— The American Association for Homecare — along with nearly 20 other organizations — has penned a letter to Congress asking them to remove a tax penalty built into the CARES Act. The coalition claims that tax-paying providers could lose at least 21% of the relief funds they received as a result of the virus if lawmakers fail to act.
— CMS is trying to make COVID-19-realted telehealth flexibilities for home health providers permanent. That was one of just a few changes CMS floated in their 2021 proposed home home payment rule. However, telehealth still wouldn’t be reimbursable or count toward LUPA thresholds. You can read HHCN’s breakdown of the 2021 proposed rule here.
— Meanwhile, nursing homes are seeing some of their coronavirus-related flexibilities go away. For example, CMS announced plans to end the blanket waiver that allowed nursing homes to have a break from staff reporting requirements amid COVID-19. Nursing homes have to start submitting staffing data again by Aug. 14.
— The global total of deaths linked to COVID-19 passed 500,000 on Sunday, according to a New York Times database. The number of confirmed cases surpassed 10 million.
What you need to know from Thursday (June 25):
— With COVID-19 cases on the rise, hospitals in parts of the nation could once again be pressed for beds. Reopenings across the country are to blame, with Florida, Oklahoma, South Carolina and Texas reporting record levels of new cases in a single day Wednesday. “Many [hospitals] still have a lot of available capacity, but who knows how long that’s going to last,” Eric Toner, a senior scholar with the Johns Hopkins Center for Health Security, told the Associated Press. “They should be getting themselves ready now.”
— Texas is doing just that: In response to the spike in cases, the state has paused its reopening and banned some elective surgeries in an effort to free up hospital space. Texas is one of 29 states where cases are on the rise, according to the New York Times, with the South and the West seeing the most resurgence.
— Meanwhile, New York, New Jersey and Connecticut are taking steps to prevent another coronavirus spike of their own. For weeks, the tri-state area was the nation’s COVID-19 epicenter. To avoid reclaiming the title, the states are mandating that travelers coming from areas with high coronavirus rates must quarantine for 14 days. Reuters has more details here.
— Although outpatient care numbers largely rebounded in June, visits are still 20% below pre-COVID-19 levels in some parts of the country, according to a new report from the Commonwealth Fund. Still, it’s a significant improvement over late April, when outpatient care was down nearly 60%. Meanwhile, the number of people receiving care in their home has soared.
— The U.S. Small Business Administration (SBA) has yet again put out new guidance for Paycheck Protection Program (PPP) loan recipients. SBA says it will allow recipients to apply for early loan forgiveness — but it could cost them, according to the Journal of Accountancy. Still, with $130 billion left in the program and just a few days until the deadline, this financial advisor says home-based care providers should set aside unlikely audit concerns and go after the money.
What you need to know from Wednesday (June 24):
— Washington, D.C.-based health care research and consulting firm Avalere Health released a new report on COVID-19’s impact on Medicare Advantage (MA). Among Avalere’s findings: Deferral of care during the COVID-19 pandemic is resulting in fewer claims and diagnoses among MA enrollees, which could lead to a 3% to 7% reduction in 2021 risk scores and lower plan payments in 2021.
— Just a few weeks ago, possible long-term care budget cuts in California threatened to kill the state’s adult day program. Those cuts appear to be on hold — for now. Despite a massive budget deficit, Gov. Gavin Newsom, a Democrat, and state lawmakers agreed on a budget plan that would avoid the deep cuts to essential health care services the governor had initially proposed, according to Kaiser Health News.
— A new New York Times op-ed by two National Domestic Workers Alliance experts called attention to the critical role home care employees and other essential workers play in the U.S. economy. “The work force that powers our economy today — in times of stability and in crisis — is a low-wage service work force that is disproportionately made up of black women and other women of color, and largely unprotected by our safety net,” authors Ai-jen Poo and Palak Shah wrote. “These workers take care of us in different ways, and it took a pandemic for the nation to recognize they are the critical engine of our economy.”
— The U.S. recorded a one-day total of 34,700 new COVID-19 cases, the highest in two months, according to Johns Hopkins University statistics. The number of new cases per day is close to the country’s late-April peak of 36,400. The Associated Press has the story here.
— The International Monetary Fund (IMF) released an update to its World Economic Outlook, predicting that the global economy will contract by 4.9% in 2020. The update is a grim revision of IMF’s initial forecast of a 3% contraction. A 4.9% global dip is the worst in the World Economic Outlook’s history.
What you need to know from Tuesday (June 23):
— On Monday, President Trump suspended new work visas and blocked thousands of additional foreigners from the road to employment in the U.S. in order to protect American jobs during the COVID-19 crisis. Health care workers involved in treating coronavirus patients will be exempt from the order, but there is some uncertainty on what the guidelines for qualifying for that exemption are. For instance, a home-based care worker may not be directly involved in the COVID-19 fight, but his or her services could be necessary to an agency that is fighting COVID-19 itself.
— COVID-19’s impact on the perception of telehealth and telemedicine continues to show itself in new surveys, including this one from Piplsay, which had over 30,000 respondents. The findings suggest that 33% of Americans have opted for telehealth at some point during the pandemic. Of those that tried it, more than 40% found it very effective and over half considered telehealth safer and more accessible.
— President Donald Trump insisted Tuesday that his remarks suggesting the U.S. should slow down COVID-19 testing were serious. “I don’t kid,” he told reporters. A slow down in testing could be tough for home-based care providers, as they are just beginning to receive closer-to-adequate access to testing.
— CMS is continuing with its quest to cut the red tape for home health providers and others in the Medicare and Medicaid programs. Such is especially important in light of the coronavirus, when providers are grappling with never-before-experienced issues and don’t have as much time for paperwork.
CMS reduces regulatory burden on providers
The Centers for Medicare & Medicaid Services (CMS) announced the creation of the Office of Burden Reduction and Health Informatics Tuesday. The office’s goal is to reduce regulatory and administrative burden on providers.
The agency said in a statement Tuesday that this was a continuation of the Patients over Paperwork (PoP) Initiative, which was a part of the “Cut the Red Tape” campaign that the Trump Administration began in 2017.
Part of the previous successes that CMS highlighted in its statement was the removal of “235 data elements from 33 items on the Outcomes and Assessment Information Set (OASIS) assessment instrument for home health” in November of 2017.
What you need to know from Monday (June 22):
— The Centers for Medicare & Medicaid Services (CMS) has issued a “renewed national commitment” to value-based care in light of new Medicare claims data. The data shows that older adults and people with chronic conditions face the highest risk for COVID-19. The new data also highlights racial and ethnic health disparities.
— While older adults are at the highest risk of contracting COVID-19, more young people in southern states are testing positive for the virus. In states such as Florida, South Carolina, Georgia and Texas, 62% of new COVID-19 cases are people who are under the age of 45, reports CNN.
— A handful of hospital trade organizations are calling for forgiveness on repaying CARES Act Medicare loans, according to Modern Healthcare.
— Several home health and home care agencies have transitioned to a fully remote workforce, with many organizations planning to stay remote even after COVID-19 goes away. But a large portion of America’s workers aren’t able to work from home, according to Axios. About 25 to 30 million front-line workers are unable to work remotely.
— The Treasury Department and the Small Business Administration said they would disclose the names of small business owners who received $150,000 or more in forgivable loans, the Associated Press reports. The agencies will reveal the general amount these businesses received, their address, demographic data and the number of jobs they helped protect.
CMS announces commitment to value-based care
The Trump administration called for a renewed commitment to value-based care on Monday, supporting its call to action with new claims data painting “an early snapshot” of the coronavirus’s impact on the Medicare population.
The new data show that more than 325,000 Medicare beneficiaries had a diagnosis of COVID-19 between Jan. 1 and May 16. That translates to 518 COVID-19 cases per 100,000 Medicare beneficiaries.
The data also indicate that nearly 110,000 Medicare beneficiaries were hospitalized for COVID-19-releated treatment, which equals 175 COVID-19 hospitalizations per 100,000 Medicare beneficiaries.
Black people were hospitalized with COVID-19 at a rate nearly four times higher than white people.
Individuals with chronic kidney disease undergoing dialysis had the highest rate of hospitalization among all Medicare beneficiaries, with 1,341 hospitalizations per 100,000 beneficiaries. The second highest rate was among beneficiaries enrolled in both Medicare and Medicaid; that “dual eligible” population had a hospitalization rate of roughly 473 hospitalizations per 100,000 beneficiaries.
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