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Healthcare Public Policy to Unite Providers and Payers for a Sustainable Future


In this Future in Focus interview, Home Health Care News catches up with Deborah Hoyt, Senior Vice President of Public Policy at Axxess, to learn more about in-home care providers’ ability to lower costs and improve patient outcomes.

HHCN: When we think about advancing home-based care, we can talk about moving the needle with a variety of key decision-makers and gatekeepers. Looking exclusively at the policy space, what are some home-based care advancements you’d like to see turn into reality?

Hoyt: We really need to have an honest conversation about Medicare home health profit margins and have the appropriate data to help us tell that story. Post-acute care – particularly home health – has been the piggy bank for healthcare delivery in the United States, and it’s just not fair.

The “fire drill” mentality that CMS creates for our industry with each release of a proposed rule is so stressful on providers. We spend an extraordinary amount of time and money as an industry reacting, responding, meeting with Congress and advocating against the CMS and MedPAC rule language in an attempt for financial and regulatory fairness.

The policy positions just don’t support the payment model and the value of healthcare delivery in the home. I’d say that home health and hospice have been extending the solvency of the Medicare program, but CMS, Congress and providers really need to come together and find a sustainable solution.

If we can make a change in the policymaking process and use our energy as a sector more effectively in partnering with CMS and MedPAC in a way that demonstrates our value using current data, we may be able to advance the process to one where we engage in a more collaborative and productive way. NAHC and PQHH have made big strides over the past few years to move us to a better position. Axxess is fully engaged and committed alongside the associations, provider sector, and key members of Congress as a “united voice” for this change.

Then there’s also advancing home-based care and advocating on behalf of providers in the context of payers, including managed care. What degree of progress has the home-based care field made in communicating their value to payers, in your view?

I certainly think that payers recognize the value of home-based care or else they wouldn’t be actively acquiring some of the largest home-based care players in our space.

The industry has now embraced Medicare Advantage to some degree, particularly the larger, more forward-thinking organizations. We need to realize that as providers we bring significant experience and leverage. We should and could be having more strategic conversations resulting in more mutually beneficial wins for both parties.

How are you and your organization contributing to those efforts?

Axxess is all-in as an industry provider partner. Starting with our CEO, to our leadership team, and all our Axxessians, we are committed to supporting the industry in every way possible through grassroots and grasstops advocacy. We have a growing Axxess PAC and an active Axxess Advocacy Network to educate our employees on federal issues and the impact on our home health, hospice and home care clients. We are in Washington D.C. regularly for key meetings with members of Congress, hold seats on all the various boards of the national advocacy organizations and are an active engine for innovation and change.

Looking ahead again, what’s on your advocacy to-do list for the upcoming year?

Working alongside the National Association for Home Care and Hospice (NAHC) and the Partnership for Quality Home Healthcare (PQHH) to stop the additional reimbursement cuts proposed for home health. Also, our Chief Technology Officer, Andrew Olowu, serves as co-chair of Home Care Technology Advisory Council (HCTAC) and is working with providers and technology partners to lead efforts with CMS to promote interoperability, data security and digital quality measures.

What trends, challenges or opportunities do you see helping – or hindering – the advancement of home-based care over the next 12 months?

We need to move CMS from the current process of issuing annual proposed rules to a partnership discussion around the value of home health and hospice to the full healthcare continuum and our sector’s contributions to Medicare cost savings overall.

Editorial Note: This article was originally published on Home Health Care News. We are sharing this piece in two parts; this is part two.

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