OASIS Alert

Published on Mon Apr 20, 2009 PDF

Medications may cause cognitive decline.

Researchers have found a key difference between profitable agencies and unprofitable ones--and it's something you can influence.

Bottom line: The most significant factor distinguishing agencies based on their profit margins is the cost per visit, according to an analysis the National Association for Home Care & Hospice performed using Medicare cost report data. NAHC examined a number of factors regarding HHA operations to determine whether any common elements correlate with provider profit margins.

Impact: For agencies with low/no margins the average per visit cost is 20 to 25 percent greater than per visit cost for high margin agencies, NAHC reported. Over the span of an average 18 visit episode, this cost differential adds up to episode costs of nearly $1,000 greater for the low/no margin agencies, NAHC told officials from the Medicare Payment Advisory Commission (MedPAC).

NAHC's Home Care & Hospice Financial Management Association (HHFMA) is presently pursuing an evaluation of per visit costs. That analysis will examine differences in direct and indirect costs, the impact of compensation methods, and other relevant factors.

Combined use of multiple central nervous system (CNS) medications over time, especially at higher doses, appears to be associated with cognitive decline in older adults, according to a study published in the February issue of the Journal of the American Geriatric Society, available at www.americangeriatrics.org.  Adjusting or discontinuing the medications can reverse the medication-induced problems.

What to do: Clinicians should use the lowest possible combined doses of CNSactive medications, particularly when treating concurrent pain and psychiatric conditions, to minimize the risk of cognitive decline, the study suggests.