During this critical time, Home Health Care News remains committed to bringing you all the essential news related to home-based care operations. At the same time, we also recognize the seriousness of the COVID-19 pandemic. In addition to our regular content, we’ll continue to highlight industry-related developments and mitigation strategies in this rolling bulletin.

What you need to know from Monday (April 20)

— The Partnership for Quality Home Healthcare (PQHH) wrote to CMS, urging the agency to consider paying home health providers for telehealth visits and more flexible certification requirements. Providers that signed the letter include Bayada Home Health Care, LHC Group and Kindred at Home, in addition to Encompass Health’s home health and hospice segment. 

— Health officials in North Carolina believe at least 14 cases of the coronavirus can be traced back to a home health agency in Rutherford County, according to local newsroom WLOS. Home health agencies can often help prevent the spread of the virus, but, like other providers, are left vulnerable when not fully equipped with appropriate PPE.

— In a Los Angeles Times op-ed, Sirina Keesara and Nicholas Bott argued on behalf of hospital-at-home models. Keesara is an obstetrician-gynecologist and fellow at Stanford University’s Clinical Excellence Research Center, while Bott is a clinical neuropsychologist and associate fellowship director at the center. “Most hospitalizations for patients with mild or moderate illness require a set of initial tests, a daily evaluation from a doctor, intravenous medication on occasion, and check-ins from a nurse a few times a day,” they wrote. “All of this can be provided in a patient’s home with current technology.”

— More home health agencies are reporting challenges associated with clinicians refusing work due to PPE shortages. They include Reliance Home Senior Services, a home health aide agency with about 350 employees in Massapequa, New York. “We’re having an abundance of people calling us for care in the house after they tested positive, and you can’t get caretakers to go to the house for them,” Dana Arnone, owner of Reliance, told Newsday.

— While there are signs that coronavirus cases are starting to level off in some places, the threat of the virus is continuing to grow in others, according to The New York Times. Growth has been particularly evident in Massachusetts.

LUPA rates rising

The Washington, D.C.-based PQHH — an industry association representing many of the largest home health providers in the country — implored CMS to take several key steps to further support in-home care during the coronavirus emergency.

“As you know, the nature of this crisis is like nothing the nation has ever experienced and the entire health care sector (including the home health provider community) has been challenged in ways that were not imaginable,” PQHH wrote to CMS. “Home health providers are experiencing significant difficulties in providing critically needed care to existing Medicare patients (whose fears about COVID19 infection cause them to restrict access to the home), a severe reduction in referrals from hospitals, nursing homes and physicians, and a significant increase in low utilization payments (LUPA payments) in place of full episode payments for existing patients. In addition, staffing challenges are widespread, with personal protective equipment (PPE) in short supply and increased costs for training, screening and other activities related to COVID19.”

Specifically, PQHH called for telehealth payment as well as flexibilities surrounding signed orders and certifications.

A lack of telehealth reimbursement, in particular, has caused “extreme hardship for providers,” in part by dramatically increasing LUPA rates.

Early data from PQHH suggests that providers are experiencing at least a doubling of their 2019 LUPA visits.

“While telehealth visits certainly do not take the place of in-person visits, during the [public health emergency], it would make policy and public health sense to facilitate telehealth for home health providers by instituting a temporary payment mechanism to count them as in-person visits,” PQHH noted.

For daily updates from the week of April 13, click here.

For daily updates from the week of April 6, click here.

For daily updates from the week of March 30, click here.

For daily updates from the week of March 23, click here.

For daily updates from the week of March 16, click here.

HHCN encourages you to reach out to us individually or at [email protected] for story ideas, tips or general feedback.