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CMS Approves Initial Group of IAH Practices from 130 that Applied
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CMS has announced the first 16 IAH practices approved to participate in the 3 year demonstration. Here is a link to the CMS Press Release and the AAHCP Press Release regarding the announcement. Congratulations to Academy members who were selected out of the 130 that applied! Additional approved practices, those that applied as consortia will be announced soon.
Press Release, Ribbon Cutting and Sponsor Thanks Recommended - Here are some recommendations as you announce your approval and get started under IAH. Please contact us for assistance with these activities.
- Produce a press release for your community and interested parties.
- Conduct a ribbon cutting event on or around the first day of June and invite your Congressional representatives (House and Senate) and their staff. Remind them of the importance to beneficiaries and to the Medicare program of having your services available to all home limited beneficiaries across the country.
- Send a letter of thanks to Congressman Ed Markey and Senator Ron Wyden as the lead sponsors of IAH.
Attend the IAH Learning Collaborative May 2 - The Academy will begin its year long IAH Learning Collaborative to enhance the opportunity for success under the Demonstration Wednesday, May 2 in Seattle. There is still an opportunity to register. Learning Collaborative attendees will participate in a clinical vignette process designed to promote clinical and organizational success and share best practices.
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What to do if Your Practice Was Not Selected
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We share your disappointment in not being selected. However, a major explanation the initial statutory limit of the demonstration to 10,000 beneficiaries.
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 beneficiary cap increased or removed.
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 is keeping the resultant savings from being achieved.
Attend Learning Collaborative Even if Not Selected to Obtain Valuable Practice Improvement Benefits - The Learning Collaborative is valuable to attend even if you were not selected under the initial capped demonstration. The Learning Collaborative is designed to enhance your practice performance and success not only for potential re-application for IAH, but as importantly to be of value across your patient populations, existing payors, and for the models and joint ventures emerging across the post-acute continuum of care.
Attendees will also hear of the Academy strategy for having the 10,000 beneficiary cap lifted and your active participation in this effort is requested.
Please contact Constance Row or Gary Swartz with any questions or comments.
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It's Not Too Late to Register for the Annual Meeting; Last Chance to Register for IAH Learning Collaborative; Make Your Plans Now!
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1. Register here for the AAHCP Annual Meeting! Click here for the updated program.
This year will feature several optional sessions and events. To help you think ahead:
2. Wednesday PM: If you have applied for the Independence at Home Demonstration, be sure to sign up for the Learning Collaborative May 2 from 1-5 PM (separate registration required). Click here to learn more and click here to register.
3. Thursday May 3, 7:00 AM, Willow Room: Education Interest Group. Join this group for breakfast outside the meeting room for the Practice Management Day. There you will give final input to the competencies list you think home care medicine providers should have, and talk about next steps in weaving these competencies into future educational programming and publications of the AAHCP. The session will be led by Past President Dr. Edward Ratner.
4. Thursday May 3, Lunch from 12:30-1:30, Willow Room: Join Board members Brent Feorene, Dr. Steve Phillips, Members Dr. Teresa Soriano and Dr. Raul Khorane in a discussion of what we know about the role of home care medicine programs in reducing hospital readmissions. Especially for those of you working with or making proposals to hospitals. (A preliminary handout will be available; a Frontiers article will come out of this session)
5. Thursday, May 3, 5:00 PM: Join us for a free Networking Reception, co-sponsored by Cleveland Clinic, Harden Healthcare, Invacare, and NAHC where you will have a chance to meet and interact with other members and unwind with snacks and drinks.
6. Friday, May 4, Lunch 12:30-1:30, Willow Room: Join Past Presidents Dr. Tom Edes and Gresham Bayne, and Dr. George Margelis in discussing the current usage of telemedicine with home-limited patients. (A handout will be be available; a Frontiers article will come out of this session).
We hope you can participate in these additional sessions and we will see you in Seattle!
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Practice Metrics Needed to Respond to Questions to Protect Your Practice
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The Academy submitted recommendations to CMS regarding the definition of housecall practices and utilization expectations in response to CMS Medical Director request. The CMS request was based on Academy efforts to reduce audit, pre and post payment medical record requests burden and in anticipation of changes in utilization based on IAH and other new delivery and payment models. A copy of the letter is available click here.
We are working to arrange the opportunity to review the field description discussed in the letter in person. As we pursue the briefing and education of CMS officials and staff on the benefits of housecalls as well as evolving patterns of utilization, we need your help through your submission of practice data to effectively advocate for your practice. Please help us in our advocacy efforts in your behalf by submitting data to the Practice Survey.
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Help the Academy Advocate for the Field and to Protect Your Practice; Win Future Annual Meeting Attendance
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The need for practice data is increasingly important as noted above to effectively advocate for your practice. Two Academy members are attending this year's Annual Meeting as the awarded incentive for submitting the most data! We are offering the same opportunity to win attendance for the 2013 annual meeting. Here is how you can win.
1) Seattle Annual Meeting Attendees - Bring a copy of 2011 year end operational and financial reports to the annual meeting. Or bring the practice survey data elements in format that is available to you. We will enter your practice data, with practice identification into the Academy survey for you.
2) Members Not Attending Annual Meeting in Seattle - Enter your practice data into the Practice Survey.
We will select a 2013 Annual Meeting attendance winner from the next 20 practices that bring or enter the most practice data elements as described above. Thank you for helping us to help you.
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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 practices 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. A group of copies will be distributed for free at the Annual Meeting. If you are not attending, order your 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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CMS Publishes Final Rule on Medicare Ordering/Referring
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CMS released last week a final rule detailing requirements for ordering and referring in Medicare. In 2009, CMS began issuing warnings for Medicare claims that failed to meet CMS's ordering and referring criteria, including requiring the ordering/referring provider have an enrollment record in the Provider Enrollment, Chain and Ownership System (PECOS). An interim final rule was in effect since 2010.
The final rule modifies the interim final rule from requiring an enrollment in PECOS to requiring enrollment in Medicare, including PECOS or other legacy Medicare enrollment systems. Providers who did do not have their NPI associated with their Medicare enrollment will want to update their enrollment record. The requirements in the final rule apply to ordered or certified items and services including DME, clinical laboratory and imaging services, and home health claims billed by Medicare Part B suppliers. For these claims, ordering or certifying providers must be eligible to order or certify in Medicare, their legal name and NPI must be listed on the claim, and they must have an enrollment record in Medicare. The final rule requires documentation and access to the documentation of orders and certifications to be maintained and available for 7 years.
The final rule can be found here. |
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HHS Proposed One Year Delay of ICD-10 Compliance Date to October 2014
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The Department of Health and Human Services (HHS) announced last week a proposed rule that would delay, from October 1, 2013 to October 1, 2014, the compliance date for the move ICD-10.
The proposed rule was developed by the Office of E-Health Standards and Services (OESS) as part of its ongoing role, delegated by HHS, to establish standards for electronic health care transactions under HIPAA. The proposed rule includes other provisions impacting electronic health transactions effecting the healthcare industry.
The delay in transition to ICD 10 was based in part to the difficulty in implementing the Version 5010 transaction standards necessary prior to implementation of ICD-10. HHS believes the change in the compliance date for ICD-10, as proposed, would give providers and other covered entities (i.e., clearinghouses and health plans), more time to prepare and test their systems to ensure a smooth and coordinated transition.
Benefit of Delay to ICD 10 is Opportunity to Focus on ICD 9 Accuracy as this Drives IAH and Similar Practice and Revenue Opportunities
One benefit of the delay in effect of ICD 10 will be for the Academy to provide additional guidance to members on ICD 9 coding particularly as IAH gets underway. IAH and related models use ICD -9 to determine the expected expenditures through the hierarchical condition categories (HCC) scoring. Accordingly, accurate ICD 9 coding will produce the appropriate HCC scoring given the multimorbid health status of your patients and improve your opportunity for success based on such programs.
The relationship of accurate ICD 9 coding and HCC scores will be reviewed next Wednesday in Seattle during the Learning Collaborative and on Thursday during the Practice Management Day of the Annual Meeting. We will also be providing additional education during the year.
The Academy will review the proposed rule and submit comments that are due by May 17.The fact sheet on the proposed rule can be found here and you can view the proposed rule here.
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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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