Goal: Reduced ER visits & hospital stays.
Although none of the six organizations chosen to participate in Medicare's three-year demonstration, Care Management for High Cost Beneficiaries, are home care providers, home care still can play a role in the demo.
The Centers for Medicare & Medicaid Services chose ACCENT, Care Level Management, Massachusetts General Hospital and Massachusetts General Physicians Organization, Montefiore Medical Center, RMS DM LLC, and Texas Senior Trails as participants.
The organizations will receive a monthly fee for each Medicare beneficiary involved in the demonstration to cover administrative and care management costs. But organizations must "assume financial risk if they do not meet established performance standards for achieving savings to Medicare," CMS says.
Beneficiary enrollment in the program will begin in fall 2005. CMS hopes the demo will promote evidence-based care, reduce unnecessary emergency room visits and hospital stays, and help patients avoid complications. The various models participants use will include support programs for health care coordination, self-care and caregiver support, physician and nursing home visits, use of in-home monitoring devices and 24-hour nurse telephone lines, education, outreach, tracking and reminders of patients' preventative care needs, and behavioral health care management. Several dozen U.S. senators have joined their House colleagues in calling for changes to Medicare's wheelchair policy. Thirty-four senators, including seven members of the powerful Senate Finance Committee, signed a letter asking Health & Human Services Secretary Michael Leavitt to change a Medicare policy preventing coverage of mobility devices for use outside the patient's home. Sens. Jeff Bingaman (D-MN) and Rick Santorum (R-PA) initiated the July 13 letter.
Earlier this year, 61 House members signed a similar letter. To view copies of those letters, visit
www.itemcoalition.org.
The medical equipment industry could soon find itself grappling with new medical device regulation.
The Institute of Medicine on July 18 released a report charging that the Food & Drug Administration lacks an effective system for monitoring medical-device safety. The panel is urging the FDA to improve its tracking of studies conducted by device manufacturers after the products are on the market and to work with the private sector to improve device tracking.
For a copy of the study, visit
www.iom.edu.
CMS recently announced a couple of new drug codes. New codes took effect this month for iloprost inhalation solution and high osmolar contrast material under the Healthcare Common Procedure Coding System.
For details, see the MedLearn Matters article on the CMS Web site at
www.cms.hhs.gov/medlearn/matters/mmarticles/2005/MM3847.pdf.
Home care company valuations are on the rise, says Pittsburgh, PA-based mergers and acquisition company The Braff Group. A successful initial public offering in June by regional home care chain LHC Group of Louisiana shows that investors are well disposed to home care.
"Such an enthusiastic market response bodes [...]
