Posted on Thursday, July 19, 2018 7:51 PM
In a few short years, the number of Americans turning 65 in a day will be 10,000 and while the demographic change holds great promise for a generation unwilling to be shunted into institutional care, policymakers are likely to be moving in the direction of reining in health care spending and resisting calls to raise payment rates. Fred Bentley, the keynote Speaker at this week’s Financial Management Conference, addressed this and other home health predictions for the coming years.
“The near future will see provider payment “inextricably” linked to metrics of cost, quality, and patient satisfaction, Bentley confidently predicted. CMS, says Bentley, is currently following a well-worn pattern from past regulatory moves. First, CMS asks providers to report data and punishes those who do not report with payment adjustments. But CMS does not collect data for no reason. The next step is to adjust payment to providers based on what they learn from the data the providers have given CMS. “We have moved into a value-based payment world,” concluded Bentley. Going forward, payment will be tied to the needs of the patient — the underlying characteristics of their maladies — rather than intensity or volume of treatment received.”
He went on to talk about how the recent regulatory change by the Trump administration with Medicare Advantage having more flexibility in what they can cover and that is very good for the industry.
Bentley concluded his address by listing some “imperatives’ for the home health agencies of the future:
- They must compete on value, readmissions, episodic costs;
- They must be willing to accept more risk in collaboration with hospitals and managed care organizations;
- They must be efficient downstream providers;
- Must be willing to consider moving upstream and getting into insurance in some markets if those companies have great administrative capacities and marketing skills.
Source: NAHC
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