Bill Carlson, Dennis Petroskey, Katie Naranjo and Eli Tomar meet with U.S. Rep. Brian Babin (R-Tex.)
As the House Republicans offered up their proposal to reform and replace the Affordable Care Act and the markup process began, more than 20 industry leaders joined the Texas Association for Home Care and Hospice’s March on Washington to advocate on critical issues affecting home care. Over three days, various representatives met with the Texas delegation in both the Senate and House to urge support for several industry priorities.
Our top priority was to encourage support to stop the Pre-Claim Review demonstration project that targets five states, including Texas. Early results from Illinois indicate PCR will raise administrative costs for home health with little or no proven return. Interactions with stakeholders and representatives from CMS suggest in its current form PCR is not manageable or realistic, and the delegation urged that the demonstration be delayed until there are adequate assurances that the demonstration effectively targets fraud and avoids risks to patients needing access to home health services.
Another key ask of our policymakers in Washington is to repeal or reform the face-to-face physician encounter documentation requirements. This CMS rule imposed burdensome, duplicative, costly and confusing documentation requirements that exceed the intent of the Congress, and as a result documentation errors have increased to over 50 percent. The increased paperwork burden has created a disincentive for physicians to recommend home health care.
A third priority is to make permanent the payment differential (add-on) for care delivered in rural areas, and ensure home care access for rural and underserved patients. Legislation has been introduced in the Senate by Sens. Susan Collins (R-Maine) and Maria Cantwell (D-Wash.) to extend the rural add-on payment in the Medicare home health benefit, but the goal is to make it permanent rather than requiring regular reauthorization.
The fourth key priority is a request that Congress work closely with the industry when considering any Value Based Purchasing proposals. It is clear that value based purchasing is going to be important in the future, and the ask is that Congress gain industry input to ensure that any payment reforms support patient-centered care, access to home care services, and use an “at-risk” payment share similar to other health care industries. VBP should base at-risk payments on a small number of true clinical quality measures that indicate patient health outcomes.
Rachel Hammon, Elyse Fulton and the entire TAHCH team set the standard for how advocacy on industry issues should be handled. It was a well-organized few days, beginning with a reception at Akin Gump, where former Congressman Tom Loeffler and the Akin Gump lobbying team familiarized everyone with the issue talking points and the meetings agenda. As a former Capitol Hill press secretary myself, I know firsthand the value in bringing in industry experts with real-world accounts of how our laws and regulations affect them. With a new Administration and new Congress grappling with how to address healthcare issues in the months and years ahead, it was a perfect time for our industry to make its voice heard.
