Thank you to the Academy members whose attendance and participation was key to the success of the recent Annual Meeting.  Attendees heard presentations here  that ranged from starting a practice through IAH and efforts to expand IAH, elder law, medical director role, incorporation of technology, managed care and private pay models and capital, pharmacology, teaching, as well as presentations on interaction with home care agencies and efforts to reduce readmissions.

 

This year included are Academy member driven lunch meeting on readmissions. This meeting will produce a Frontiers article and materials for you to recommend housecall involvement in readmissions reduction efforts with your community hospitals.

 

Academy appreciation goes to Dr. Steven Landers and the Planning Committee members and to sponsors who exhibited and supported speakers, breaks and networking opportunities such as the Thursday evening reception that enhanced collegiality, learning from each other and raised the level of the meeting.

 

We are already using your comments to make sure your 2013 Annual Meeting in Texas is as relevant, beneficial and successful as the just concluded 2012 meeting. You can help by participating in the Annual Meeting Planning Committee and you will see additional information on how to participate over the summer.  And for those who attended as well as those unable to attend this year, the slides of presentations are posted on the Academy site here and a thorough review of the Annual Meeting is being prepared for the June edition of Frontiers. 

 

President Dr. Bruce Leff and member Dr. Jen Hayashi published an excellent summary of home care medicine programs in the Generations publication of the American Society on Aging. Click here for a copy. 

 

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 framework and purpose of the Learning Collaborative and the process of facilitated interactive problem solving that will be followed.

 

Faculty members Drs. Bayne, Boling, Kinosian and Taler then led attendees through clinical vignettes designed to focus attention on patient care, information considerations and practice design/redesign for success. These considerations were discussed in terms of anticipation of patient needs, and practice design and redesign. Gary Swartz, Associate Executive Director, walked through a theoretical IAH pro-forma to illustrate the benefits of success under the shared savings model.

 

The Learning Collaborative will continue through a group call in June focusing on top concerns of practices as they begin service to eligible beneficiaries under the Demonstration.

 

IAH Expansion Efforts Underway

 

Jim Pyles, Esq., noted at the Learning Collaborative and during the Annual Meeting the good news that the initial CMS solicitation for practices received overwhelming response (over 130 applicants), and that this strong response from the homecare medicine field will support efforts already underway to expand IAH with the ultimate goal of IAH benefits being available to all Medicare beneficiaries in need.

 

Related to the positive role of IAH, its expansion and Medicare program cost saving, is the introduction of legislation to move to a new payment system for Medicare Part B services, and to resolve the sustainable growth fate issue. You can help by donating to the Academy's (c)(4) Homecare Medicine Action Fund.

 

Again, thank you for your attendance and participation to make the 2012 Annual Meeting the best ever.  Please contact Constance Row or Gary Swartz with any questions.

The Academy submitted comments on the CMS Meaningful Use Stage 2 Proposed Rule. The Academy also signed onto a comprehensive letter drafted by the AMA that reflected the varied concerns of organized medicine. Academy comments emphasized the following concerns.

 

1. Eligible Providers Should Not Be Accountable for Meaningful Use Dependant on the Resources and Competencies of their Medicare Part Beneficiary Patients
2. Broad Based Exemption Should Be Developed to Apply to Practices Whose Service is Predominately Mobile and Where Internet Connectivity is Not Assured nor Consistent Across the Housecall Practice
3. Measures Should Have an Exclusion Opportunity Based on Impracticability of Meeting the Measure
4. The Exemption for Lack of Pharmacies for 25 Miles Should be Reduced from 25 Miles and Replaced with an Area Accessible by the Patient in Context of the Patients Condition.

 

CMS Releases Proposed Rule to Increase Medicaid Rates to Medicare Levels for 2013 and 2014 as Required by the Affordable Care Act; Beneficial to Academy Members Serving Medicaid and Dual Eligible Beneficiaries

 

CMS released a proposed rule and accompanying fact sheet on 2013 and 2014 payment increases for Medicaid primary care services. This increase in Medicaid payment rates for physician (and physician supervised) primary care services for each of the 2 years is required under the ACA. 

 

CMS proposes that the evaluation and management services of primary care providers be increased to Medicare levels. Primary care physicians will those Board-certified in family medicine, general internal medicine, or pediatric medicine or related subspecialists of each specialty as recognized by the American Board of Medical Specialties, or, for physicians who are not Board-certified those who have rendered evaluation and management (E&M) services and vaccine administration services for at least 60 percent of their Medicaid codes billed during 2012.  The proposed rule is here. 

 

The two-year payment increase whose additional cost to states is 100% offset by increased federal cost sharing coincides with the estimated 16 million new Medicaid beneficiaries who will become eligible for the program in 2014. The increase in payment levels for primary care services will also apply to Medicaid managed care plans and CMS proposes methods to assure that providers receive the value of additional payments regardless of whether they are paid FFS or capitated by the Medicaid managed care plan.

 

There are additional beneficial aspects to the proposed rule and we provide these in future E-Newsletter, Frontiers and the Academy will also be submitting comments.  

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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