This article is sponsored by Axxess. In this Voices interview, Home Health Care News sits down with Deborah Hoyt, Senior Vice President of Public Policy for Axxess, to learn why public policy engagement is so important for home-based care organizations today. She also discusses the public policy work being done at the national level across all service lines, and she explores some of the innovative thinking around public policy in the home-based care space.
Home Health Care News: What career experiences do you most draw from in your role today?
Deborah Hoyt: I’ve been in health care for four decades, working both in non-profit and for-profit settings across the full continuum. I’ve held communications, public affairs and lobbying roles for a major hospital, a regional managed care plan and a Fortune 500 health insurance company, as well as a state hospital association, and most recently serving as the CEO of the Connecticut Association for Healthcare at Home.
Each of these experiences provided me a unique perspective from inside these organizations. And when combined, they enable me to fully understand the motivation and financial drivers around payers acquiring home health agencies and hospitals ramping up hospital-at-home practices.
Right now, each sector is seeking relevance and control, along with defining its own slice of the health care dollar. The “build it and they will come” mentality of the inpatient brick-and-mortar hospitals and outpatient service centers has quickly been replaced with the home care-first mindset post-COVID.
Each role I’ve held has required a constant balancing act of strategic messaging and advocacy, both on offense and defense, but mostly on the defense. Bottom line legislative and regulatory challenges are a constant in every sector of health care, so active engagement is a must for agencies and providers.
Why is public policy engagement so important for organizations?
We all know that legislative and regulatory changes have a serious impact on the day-to-day business operations and financial viability of home-based care organizations. Public policy leadership engagement at the highest levels of government is critical for a few reasons. First, to build upon our collective vision of high-quality patient and family-centered health care in the home. Next, to ensure a fair state and federal regulatory environment for businesses to operate within. And last but not least, to secure the financial viability of our providers so they can invest back into their businesses. This will also enable providers to upgrade their technology and pay a fair wage to their workforce, all with the goal of growing their businesses to increase access to home-based care for the people that need it.
What kinds of success are your clients seeing with respect to public policy engagement? What do you see as the ROI?
Axxess as a technology partner is engaging directly in policy conversations so that we can shape federal policy and anticipate well in advance how our Axxess software solution must evolve to lead and outpace all technology companies in our space.
At its core, Axxess wants to be an integral partner with all providers in the home-based care space so that together, we can create the future we know is best for individuals. Public policy engagement will define where our home-based care system will land as we sort out the evolving value-based delivery system. If we’re not actively engaged with lawmakers, we will see other entities fill the void and dominate the care-at-home space.
We are engaging our clients in industry issues to amplify the united voice. Axxess believes strongly in the value of our national associations, and we hold board and committee seats on each of those national associations, as well as several state associations. We encourage providers to get involved with associations and make sure that they pay attention to some of the state lobbying opportunities around Medicaid issues.
For example, the federal government provided an increase in the Federal Medical Assistance Percentage (FMAP) to state Medicaid departments, and we’re seeing real ROI at the state level. In New Jersey, Pennsylvania and North Carolina, they’ve seen significant provider rate increases in Medicaid home health rates as high as 20%.
That’s a result of direct lobbying and advocacy by the state associations and the home health providers in those states. When you talk about ROI, we’re definitely seeing tangible results from active grassroots engagement.
Which challenges can public policy work make the biggest impact?
Legislative issues will see the greatest effect. Once you’ve built relationships with elected officials and educated them about the value of home-based care, whether through patient testimonials or having them ride along on home health visits, securing a legislator’s support on our issues is significantly easier. State legislatures move quickly, and we often see bills passed in a single session. Moving a bill through Congress on the federal side can take 7 to 10 years, and that work is a lot more challenging in terms of relationship-building. The challenges there revolve around personal and lasting relationship-building, and the longevity of the bill or issue on the table.
Describe the public policy work being done at the national level across all service lines.
I will try to keep this relatively condensed by focusing on one issue for home health, one for hospice and palliative care, and one for non-medical home care. On the home health side, we’re most concerned with reimbursement. The number one priority in this space right now from a policy perspective is passing the Preserving Access to the Home Health Act in Congress.
That would prevent the 7.69% reimbursement cut to Medicare home health providers until 2026. This has been the most unified and intense advocacy push I’ve ever seen, and I’ve been in the industry for 40 years.
On the hospice and palliative care side, the one bill that’s been revisited over the past couple of years is all about workforce and training, and that’s the Palliative Care and Hospice Education and Training Act (PCHETA).
PCHETA provides an opportunity to improve the interdisciplinary, team-based training of health care professionals, and to look at retraining faculty at accredited medical, nursing and social work schools, as well as other programs. It offers a way to lay the groundwork with a fully educated workforce to push hospice and palliative care, and advance it into the future. We’re seeing tremendous growth there, and we need to bolster the workforce with this type of education to ensure its success.
Lastly, there’s a bill that the Home Care Association of America (HCAOA) is pushing, and that’s the Enhancing American Retirement Now (EARN) Act. This bill was created to improve access to non-medical services as people age in place. It is structured to allow people to have their retirement plans distribute up to $2,500 a year to help pay the premiums for long-term care insurance. We’re finding that people don’t have money at the end of life, and if they don’t have long-term care contracts and insurance, we’re going to see a lot more people on Medicaid, which will put a tremendous strain on the entire system.
What innovative thinking are you seeing around public policy, and how can people become inspired by new ways of thinking?
One thing I’m seeing specifically around this Medicare Home Health campaign is the strategic relationship-building of Political Action Committee (PAC) giving. We’re seeing that significant contributions to key members of the US House and Senate around specific policy issues with precise timing are very effective. Instead of spreading $500 PAC contributions over 100 different candidates or 100 different lawmakers, we’re seeing a more targeted, precision strategy of PAC giving, which has been more effective in building our legislative champions and leaders to push our bills through.
The patients and families will continue to inspire us and drive us to get through the challenges we’re experiencing today, and it surely has been a challenging time with COVID. Health care in the home is the future, and we all know it. It’s our time. We’re getting there. I just think we have to be patient and know that we’re in the right place at the right time.
In anticipation of the future, Axxess is bringing industry leaders together around these new ways of thinking and creating opportunities to learn from emerging leaders outside of the space with events like its first-ever Industrywide conference called AGILE, which stands for Axxess Growth, Innovation and Leadership Experience.
Finish this sentence: “The top strategy that care providers should employ in 2022 to best prepare for 2023 is…?”
Learn to embrace Medicare Advantage.
Editor’s note: This interview has been edited for length and clarity.
The Axxess Growth, Innovation and Leadership Experience, known as AGILE, will bring together the brightest thought leaders, policymakers, technology innovators, and care teams to envision a shared future of healthcare at home. Sessions will help attendees utilize leading-edge solutions and leadership approaches to solve the challenges we face and build the future of care at home, together. Don’t miss out on this unique experience, click here to learn more.
The Voices Series is a sponsored content program featuring leading executives discussing trends, topics and more shaping their industry in a question-and-answer format. For more information on Voices, please contact [email protected].