BAYADA GAO’s federal affairs team supported both the Partnership for Quality Home Healthcare (PQHH) and the National Association for Home Care and Hospice (NAHC) in lobbying both Congress and the Centers for Medicare and Medicaid Services (CMS) to reduce the reimbursement cut mandated by the Patient Driven Groupings Model (PDGM) from 8.36% to 4.06%. This reduction in the rate cut, effective January 1, 2020, saves BAYADA more than $11 million in annual gross revenues. While the industry was successful in having the reimbursement cut reduced by more than 50%, it still faces further cuts based on behavioral assumptions. This partnership of BAYADA and national associations will continue into 2020 with the goal to eliminate any further cuts made based on assumed behaviors and limiting future reimbursement cuts and increases to 2%.
BAYADA led the Partnership for Quality Home Health’s (PQHH) first annual Home Visit Program by providing specific guidelines so that the industry continues to be consistent in its efforts to educate legislators on the value of home health. Each quarter BAYADA was represented in several tactics (office visits locally or in Washington D.C., action alerts, town halls, comment submissions) that essentially led to the reduced reimbursement cut, and led a federal home visit in Florida with Congressman Vern Buchanan (R-FL). BAYADA continues to be recognized for our grassroots efforts on a national level within the industry.
GAO, along with the Hospice Action Network (HAN), lobbied MedPAC and successfully reversed MedPAC’s recommendation to cut hospice reimbursement in 2020 by 2%, saving BAYADA a potential revenue loss of nearly $1.5 million in 2020.
BAYADA’s Government Affairs Office (GAO) offers employees and clients many ways to get involved in advocacy through our Hearts for Home Care program. One of the very easiest ways to get involved with advocacy right from your cell phone or desk is by taking action on an Action Alert. Generally, GAO will send out an action alert email to all employees, or employees in a certain state, when a piece of legislation requires support or opposition from our elected officials. Action alerts take two minutes to complete and most of the work is done for you—All you need to do is click a couple of buttons in order to send a pre-written email to your legislators to encourage their action!
During the previous quarter, GAO sent out two federal action alerts to all BAYADA office staff. The first alert was sent on February 14 and requested that employees take action to urge their officials to support a bill to counteract certain sections of the Patient Driven Groupings Model (PDGM) that would be harmful to our Home Health staff and clients. The second alert was sent on February 27, and asked that employees urge their federal legislators to support action to revise an outdated Medicare requirement to allow non-physician practitioners (NPPs), such as nurse practitioners and physician assistants, to certify a patient’s eligibility for coverage of home health services. You can still take action on this alert here.
See the results of both action alerts below. Congratulations to the Firewheel and Flame Lily divisions, which had the most participation in these two alerts! We are proud of your commitment to advocacy and your dedication to speaking to our many clients that do not have the voice to speak for themselves!
Thank you to the many employees that took action and encouraged their peers to do so as well. As you can see from the below charts, both alerts—which both impact our Home Health employees and clients the most—continue to see relatively low participation. It’s important that we share our voices wherever possible, and particularly for Action Alerts that are easy to complete. We are hoping that all BAYADA employees recommit to advocacy. During the next federal action alert we hope to see 50% or more office staff participation.
CMS recently finalized calendar year 2019 and 2020 payment changes for home health agencies. The new payment model, also known as the Patient Driven Groupings Model (PDGM), was finalized on October 31, 2018. There is some good news: We will see Medicare payments increase by 2.2%–or $420 million–based on finalized policies this year. The reimbursement rate increase is the first the home health industry has received in a decade. Unfortunately, the final rule addresses that home health will see a decrease of payments by 6.42% based on the use of “behavioral assumptions” which will take effect January 2020.
Luckily Congress is working with the industry and has introduced corrective legislation into the House and Senate that counteracts this measure. Several of our legislative champions, including Vern Buchanan (R-FL), sponsored one of the three bills introduced, each of which would serve to counteract the “behavioral assumptions” by requiring Medicare to implement adjustments to reimbursement rates only after improper behavioral actions by home health agencies are actually observed affecting Medicate spending rather than assuming those improper activities will occur. While this is a great first step, weneed more legislative support to ensure that one of these bills crosses the finish line.
How can you help? The Government Affairs Office (GAO) has been working diligently to meet with key legislators and introduce them to our issues and those of our staff and clients, but we can’t do it alone. BAYADA has been asked to take the lead of home visits for our industry and we need office staff to help us communicate the importance of home care and proper Medicare reimbursement for our services.
To join in our advocacy efforts, please consider meeting with your federal Congressman or Senator through an office visit or home visit. Contact GAO Federal Associate Lindsey Wright today to learn more and to coordinate. The Federal Affairs team has a busy first month of the year and will be making visits to Home Health offices the year to hear what is most important in your office and how we can help.