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AAHCP Annual Meeting Slides Now on Website!
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Thank you to the Academy members whose attendance and participation contributed to the success of the recent Annual Meeting. Presentations here ranged from starting a practice through IAH and efforts to expand IAH, elder law, medical director role, incorporation of technology, managed care, private pay models and capital, pharmacology, teaching, as well as presentations on interaction with home care agencies and efforts to reduce readmissions.
The Academy paper regarding reduction in readmissions and the role of housecalls developed from your contribution at the Annual Meeting is under final review and will available for your program expansion and marketing use soon.
We have also started to use your comments and evaluations to make sure your 2013 Annual Meeting in Texas is as relevant, beneficial and successful as the just concluded 2012 meeting. And the June edition of Frontier's will provide a comprehensive annual meeting wrap-up and will also include a call for members to participate on the Planning Committee for 2013.
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IAH Expansion Efforts Underway - How You Can Help and What to do if Program Not Selected
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IAH Expansion Efforts Underway
CMS officials have acknowledged the difficulty in initial practice selection due to the high number (130) of programs that applied as well as the statutory cap of 10,000 beneficiaries. CMS followed the criteria in the posted application and specifications in selecting the initial IAH practices. CMS is also to announce the approved consortia practices in June. The Academy is involved in efforts to expand IAH. You can help by donating to the Homecare Medicine Action Fund.
What to Do if You Applied and Were Not Selected - Here is What to do Now
1) Provide us by E-Mail as soon as possible for your practice;
(a) Years of experience providing home-based primary care,
(b) Number of IAH eligible beneficiaries in current practice, and
(c) Number of IAH eligible beneficiaries you could treat within the next year in addition to the number in (b).
We will use this critical information in the effort to have the number of eligible beneficiaries increased.
2) Contact your Representatives and Senators and let them know that their Medicare constituents are suffering without timely needed care and Medicare funds are not being used effectively because the 10,000 beneficiary cap is preventing needed medical care from being provided and keeping the resultant savings from being achieved.
The kick-off meeting of the Academy grant funded learning collaborative took place on May 2 prior to the Annual Meeting in Seattle. The Learning Collaborative was attended by practices announced as IAH practices, those awaiting selection as consortium practices, and also those practices interested in the model and selection under a hoped for expanded beneficiary and practice opportunity. Constance Row, Academy Executive Director, described the purpose of the learning collaborative and the process of facilitated interactive problem solving.
Next Meeting of The Learning Collaborative will be through a June call focusing on top concerns of practices as they begin service to eligible beneficiaries under the Demonstration.
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Support Your Field Through Participation on Education Committee
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A strategic goal of the Academy was to establish an Education Committee. This committee is now in place under the chairmanship of Dr. Ed Ratner. The charge of the Education Committee is to promote competencies related to home care medicine among members and other professionals through live, print and electronic educational interventions. Support your Academy and field by participating on the Education Committee. Please click here to let us know that you are interested in serving on the Education Committee and subcommittees.
The Committee with also help identify and respond to opportunities for fund development and collaboration with other organizations related to education. The Committee will provide leadership in evaluation of AAHCP educational efforts. Sub-committees and their responsibilities related to the charge and competencies include;
- Live Events Sub-Committee - responsible for Annual Meeting/Other CME Program Directors
- Publications Sub-Committee - responsible for Frontiers, Field Guide and Other Booklet Editing
- Teaching Sub-Committee - responsible developing for content for those teaching students of the health professions, in medical schools for now, and to include other settings in the future.
Your service on the Education Committee immediately ties into next year's annual meeting as there is interest in having the annual meetings serve as a formal forum for dissemination and acquisition of competencies for Academy members.
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Academy Member News - Washington Hospital Center House Call Program Recognized; Indiana U Program Gains Medical Home NCQA Top Status
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Congratulations to Dr. Eric De Jonge, Dr. George Taler and the entire Medical House Call program at MedStar Washington Hospital Center. The program is a recipient of a Leadership in Aging Award from Seabury Resources for Aging. Seabury is a not for profit that serves 1,000 older adults and caregivers each day. Dr. De Jonge will accept the award on behalf of the program at a Leadership in Aging Celebration on June 7.
Congratulations also to Dr. Robin A. Beck, as Medical Director and to her House Calls for Seniors program at Wishard Health Center and the Indiana University School of Medicine in Indianapolis. The House Calls program there was awarded the highest level (Level 3) of NCQA's PPC-Patient Centered Medical Home (PCMH) recognition. This recognition was after 2 years of work and is unique for non-office based practice. Congratulations to Dr. Beck and the House Calls for Seniors program.
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Medical Management of the Home Care Patient - Updated and Available for Your Use!
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The Academy is pleased to announce an updated and expanded Medical Management of the Home Care Patient (MMHCP) is Now Available. This important publication for care of your patients and operating a home care medicine practice is updated with the most current and relevant material. This book is applicable to the practice and patients of all Academy members including physicians, nurse practitioners and physician assistants. Leaders of your Academy in conjunction with the AMA authored the MMHCP. Order you copy here.
This 4th edition, like the field of home care medicine, has grown across many aspects of care, organization and regulation and covers the changing landscape from care of special populations, relationships with community based long term care supportive services through skilled nursing and therapy services to the latest in acute hospital in the home programs.
Specific topics include:
- The basis for care of the home care medicine patient.
- Care transitions and the importance of care transitions in reducing hospital readmissions.
- Legal, compliance and ethical issues that arise or are present in practice of home care medicine.
- The Veterans Administration's Home Based Primary Care Program.
- Special home care medicine populations from neonatal through hospice and end of life care.
- A caregiver self-assessment tool.
- A comprehensive glossary.
- Listing of national, state and local resources.
- Case studies, tables, figures and easy-to-read text.
- A continuing medical education component for physicians interested in obtaining AMA PRA Category 1 Credits™
The MMHCP is a care delivery complement to the expanded Field Guide to Home Care Medicine and both beginning and growing practices will want to have both references.
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OIG Releases Study on Coding Trends of Medicare Evaluation and Management (E&M) Services; Recommends that CMS Review Physicians Who Reflect History of high E & M Code Submission; Housecalls Only 1.6% of Medicare E & M Payments for 2010
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The OIG released a study on the growth and trends of E&M services that grew 48% from 2001 to 2010 while Part B cost grew 43% overall during the period. The OIG noted that E&M services have been vulnerable to fraud and abuse. OIG findings include that physicians in general increased their billing of higher level versus lower level E&M codes.
The OIG found 1,700 physicians of 442,000 (across all specialties of Part B providers), submitted the 2 highest level codes for their settings 95% of the time or more (compared to the average across all physicians of 53% of the time). This was a statistical evaluation and the OIG did not request nor review documentation for the services. The OIG study found no geographic, specialty, nor patient condition explanation for the difference in coding of these 1,700 physicians to all others.
Housecalls and the OIG Study - The study provides that housecalls reflect only 1.6% of total E & M payment for 2010. Housecalls also reflected the same shift to the right in terms of E & M code selection seen across all specialties and settings over the period. The Academy will analyze and develop comments on this finding and will incorporate these comments into advocacy materials provided to medical directors and other interested parties.
CMS concurred with the OIG recommendations to continue education and contractor review of E & M services. CMS also stated that each Medicare Administrative Contractor (MAC) will be directed to focus on the top high billers in its jurisdiction. CMS acknowledged that CMS and the MACs must weight the cost and benefit of E&M reviews against reviews of more costly Part B services. This is one of the arguments the Academy has been making on your behalf - that is CMS/ MAC focus on low unit cost services (such as housecalls), particularly those that contribute to avoidance of higher cost services such as ER visits and hospital admissions is not a cost effective use of program review funds. This discussion will be included in a meeting that Academy leadership has with Dr. Janet Lawrence, a CMS/WellPoint medical director on June 8.
The OIG study can be found here.
Academy resources to assist you with E&M coding can be found under the Practice Management section on the site and in particular in the Webinar conducted on November 22, 2011. Slides from this webinar are here.
The next practice management webinar will focus on diagnostic coding and will be held in June.
Interestingly, the study was released at the same time another study found that physician services are no longer the biggest explanation of medical care in the employer/private health plan market.
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Milliman Medical Index (MMI) for 2012 Reflects Physician Services Growing More Slowly than Others and That Physician Services Explain Shrinking Percentage of Health Expenditures
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The just released MMI for 2012 that focuses on employer/privately insured market (and hypothetical family of 4), reflects that physician costs increased 5.0% over the prior year and this percentage increase was less than that year over year for inpatient services, outpatient services, pharmacy, and that of medical care overall. Moreover, physician services as a percent of overall medical cost in this market are now a shrinking percent of the total and equal on percentage terms (32%) with inpatient care.
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Please contact Gary Swartz, JD, MPA at 410-679-5857 or Gary.Swartz@aahcp.org to discuss these or any other practice management issues or questions. |
Since 1988, the American Academy of Home Care Physicians has served the needs of thousands of physicians and related professionals, agencies and organizations interested in improving care of patients in the home.
Academy Board member volunteers and members work to reduce barriers to providing home care medicine and to enhance practice education. Notable successes include: fostering increased reimbursement, sponsoring multiple educational and scientific seminars, and providing the practice community with a variety of helpful publications.
Academy members include home care physicians - physicians who make house calls, care for homebound patients, act as home health agency medical directors, or who refer patients to home care agencies. They also include nurse practitioners, physician assistants, home health agencies, hospital systems and consultants interested in the field.
Members come from all across the United States. We also have some international members. The Academy welcomes student affiliates and corporate sponsor-members.
Constance F. Row, LFACHE
Executive Director |
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Are you taking advantage of all your member benefits? | | |
Being a member of the AAHCP comes with a number of members only benefits. We hope that you have taken advantage of all your membership has to offer. If not, click here to see what you are missing and how to make the most of your membership with us! |
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Practice Management and Technical Assistance Services | |
Access your Academy's "Practice Management and Technical Assistance Services" to obtain answers to your practice management questions. Listen to recent feedback:
"Thank you for talking to me today -- I learned a lot"
--Mary Ann Crumlish, PA-C
Comfort Care Medical Group
Jacksonville, FL
" The Academy has great resources."
"The fact that you called shows you care"
--Lyn O'Brien, PhD, ANP/GNP-BC
The Geriatric Center for Home Health Care
Franklin, MA
"Thanks again to the AAHCP for channeling our concerns and offering guidance and advocacy."
--Andrew Lyons, MD
Medical House Calls
New York, NY
The Academy's Practice Management and Technical Assistance Services are led by Gary Swartz, JD, MPA Associate Executive Director of the AAHCP who brings his extensive practice management service to your immediate aide.
Click here for more information. |
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Start Benchmarking Your Practice/Program Against Home Care Medicine Guidelines | |
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Unsure about whether your program meets "best practice" standards as a clinical practice? Find out now by buying Recommended Clinical Practice Guidelines for Quality Home Care Medicine.
This important document representing the collective wisdom of Academy experts with over 100 years of experience in the field will give you the guidance you need so you'll see where you are and where you need to go.
Guidelines can be bought as part of the Home Care Medicine Field Guide, click here to subscribe.
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