/ en Fri, 25 Apr 2025 17:20:08 -0500 Tue, 19 Nov 24 06:00:00 -0600 /aha-center-health-innovation-market-scan/2024-11-19-providence-and-compassus-partner-launch-home-health-care-joint-venture <div class="container"><div class="row"><div class="col-md-8"><p><img src="/sites/default/files/inline-images/Providence-and-Compassus-Partner-to-Launch-Home-Health-Care-Joint-Venture.png" data-entity-uuid="357bd3ce-1d05-474f-8fa9-07fb33dc1a70" data-entity-type="file" alt="Providence and Compassus Partner to Launch Home Health Care Joint Venture. A home-health nurse takes an elderly man's blood pressure in his home." width="100%" height="100%"></p><p><a href="https://www.providence.org/" target="_blank" title="Providence homepage">Providence</a> health system <a href="https://blog.providence.org/national-news/providence-and-compassus-announce-joint-venture-for-home-based-care-services" target="_blank" title="Providence Blog: Providence and Compassus announce joint venture for home-based care services">announced a new joint venture</a> with home care provider <a href="https://www.compassus.com/" target="_blank" title="Compassus homepage">Compassus</a> to expand its reach in the home health market. The joint venture, “Providence at Home with Compassus,” will deliver a comprehensive range of services, including home health, hospice, community-based palliative care and private-duty caregiving.</p><p>Under the partnership, Compassus will oversee operations across 24 home health locations in Alaska, California, Oregon and Washington, along with 17 hospice and palliative care sites in Alaska, California, Oregon, Texas and Washington. According to Providence Chief Financial Officer Greg Hoffman, the initiative addresses the rising demand for home health and hospice care among aging populations. By expanding home health services, Providence aims to reduce the length of hospital stays and enhance post-acute care options, allowing for higher patient volumes in acute settings.</p><p>This expansion aligns with Providence’s efforts to improve patient-processing efficiency and bolster revenue following financial setbacks during the pandemic. Providence recently achieved operational profitability for the first half of the fiscal year, partly due to initiatives that <a href="https://www.fiercehealthcare.com/providers/halfway-through-2024-providences-operations-600m-over-last-year#:~:text=the%20prior%20year.-,These%20came%20alongside%20greater%20access%20to%20post%2Dacute%20care%20that%20fueled%20a%204%25%20decrease%20in%20length%20of%20stay%2C%20management%20said%20in%20a%20filing.,-Outside%20of%20the" target="_blank" title="Fierce Healthcare: Halfway through 2024, Providence's operations up $600M over last year">cut patient lengths of stay by 4%</a>.</p><p>The <a href="https://www.grandviewresearch.com/press-release/global-home-healthcare-market" target="_blank" title="Grand View Research: Home Healthcare Market Size To Reach $666.91 Billion By 2030">global home health market is projected to reach $666.9 billion by 2030</a>, driven by growing demand among aging populations and increased telehealth adoption.</p></div><div class="col-md-4"><p><a href="/center" title="Visit the AHA Center for Health Innovation landing page."><img src="/sites/default/files/inline-images/logo-aha-innovation-center-color-sm.jpg" data-entity-uuid="7ade6b12-de98-4d0b-965f-a7c99d9463c5" alt="AHA Center for Health Innovation logo" width="721" height="130" data-entity- type="file" class="align-center"></a></p><p><a href="/center/form/innovation-subscription"><img src="/sites/default/files/2019-04/Market_Scan_Call_Out_360x300.png" data-entity-uuid data-entity-type alt width="360" height="300"></a></p></div></div></div>.field_featured_image { position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } .featured-image{ position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } Tue, 19 Nov 2024 06:00:00 -0600 Home Health /news/headline/2024-11-01-cms-releases-cy-2025-home-health-pps-final-rule-partially-delays-behavioral-adjustments <p>The Centers for Medicare & Medicaid Services today issued its calendar year 2025 final rule for the <a href="https://www.federalregister.gov/public-inspection/2024-25441/medicare-program-calendar-year-2025-home-health-prospective-payment-system-rate-update-quality">home health prospective payment system</a>. Overall, this rule will increase HH payments by $85 million, or 0.5% compared to CY 2024. This update is the result of a 3.2% market basket update, offset by a 0.5% productivity reduction. In addition, CMS says payments will be reduced by 0.4% overall due to changes to fixed-dollar loss ratio for outlier payments. Further, CMS is applying a behavioral adjustment of -1.8% as required as part of implementation of the new Patient Driven Groupings Model. This reduction is half of the -3.6% CMS originally proposed due to concerns raised by AHA and other stakeholders about the impact further reductions will have on access to care. However, the agency states that it will apply the remainder of this permanent adjustment in future years. <br><br>For the Home Health Quality Reporting Program, CMS finalized its proposal to adopt four new standardized patient assessment data elements related to social determinants of health beginning with the CY 2027 program. In addition, the agency finalized a new Condition of Participation that sets standards for patient acceptance-to-service policies for HH agencies, as well as a new data reporting standard on respiratory illnesses for long-term care facilities beginning Jan. 1, 2025.</p> Fri, 01 Nov 2024 15:15:40 -0500 Home Health /aha-center-health-innovation-market-scan/2024-09-17-key-insights-health-cares-top-consulting-needs <div class="container"><div class="row"><div class="col-md-8"><p><img src="/sites/default/files/inline-images/Key-Insights-on-Health-Cares-Top-Consulting-Needs.png" data-entity-uuid="86a03555-3295-4aeb-b190-a6e227df3566" data-entity-type="file" alt="Key Insights on Health Care's Top Consulting Needs. A diverse group of hospital executives meet with a consultant to discuss operational improvements, expanding home health care, and cyber-risk management and cybersecurity." width="100%" height="100%"></p><p>When it comes to improving performance in their most pressing business, clinical and operations areas, health care leaders often turn to management consulting firms for analysis and guidance. A recent <a href="https://www.modernhealthcare.com/finance/management-consulting-firms-survey-takeaways-home-health-value-based-care-mergers" target="_blank" title="Modern Healthcare: Healthcare consultants weigh in on top trends, challenges">Modern Healthcare poll</a> of 31 health care consulting firms identified the most common areas hospitals and health systems are seeking help.</p><h2><span>Here Are Some Other High-Level Findings</span></h2><ul class="red"><li class="red"><h3>Operational improvements remain a top focus.</h3><p>Four out of five responding firms said their hospital and health system clients are seeking help in this area, including:</p><p><img src="/sites/default/files/inline-images/Operational-improvements-digital-health-transformation-finances-patient-safety-real-estate.png" data-entity-uuid="951957d7-e9dc-4b10-bfe4-565214c30f7c" data-entity-type="file" alt="68% Digital health transformation. 61% Guidance on improving finances. 42% Patient Safety. 42% Real estate." width="100%" height="100%"></p></li><li class="red"><h3>Expanding home health care gets greater attention.</h3><p>Home health care models enabled by virtual care, digital front door systems and remote patient monitoring are gaining traction, one respondent noted. Another noted that greater focus on home health care delivery will meet the needs of patients and providers who are trying to minimize hospital visits.</p></li><li class="red"><h3>Cyber-risk management, threat detection need improvement.</h3><p>Despite working with clients in this area and improving readiness and resiliency, consultants said there is much to be learned. Despite an increase in breaches, training to reduce provider downtime and improve business continuity planning after an attack often are underestimated or neglected, one consultant said. Securing needed investment and authority for cybersecurity leaders remains a challenge, said another respondent.</p></li></ul><hr><h2><span>Learn More</span></h2><p>For information on how to improve your organization’s response to cyber threats, attend the AHA Leadership Scan <a href="https://aha-org.zoom.us/webinar/register/1817236608897/WN_6uNdfOWFRuGnd9LM7ATiTw#/registration" target="_blank" title="ZOOM: 09-26-24 Navigating the Health Care Cybersecurity Storm: Strategies for Resilience and Risk Reduction Leadership Scan webinare registration">“Navigating the Health Care Cybersecurity Storm: Strategies for Resilience and Risk Reduction.”</a> The panel discussion, led by John Riggi, the AHA’s national adviser for cybersecurity and risk, will take place from noon to 1 p.m. CT on Sept. 26.</p></div><div class="col-md-4"><p><a href="/center" title="Visit the AHA Center for Health Innovation landing page."><img src="/sites/default/files/inline-images/logo-aha-innovation-center-color-sm.jpg" data-entity-uuid="7ade6b12-de98-4d0b-965f-a7c99d9463c5" alt="AHA Center for Health Innovation logo" width="721" height="130" data-entity- type="file" class="align-center"></a></p><p><a href="/center/form/innovation-subscription"><img src="/sites/default/files/2019-04/Market_Scan_Call_Out_360x300.png" data-entity-uuid data-entity-type alt width="360" height="300"></a></p></div></div></div>.field_featured_image { position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } .featured-image{ position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } ul.red { list-style: none; } ul.red li.red::before { content: "\2022"; color: #9d2235; font-weight: bold; display: inline-block; width: 1em; margin-left: -1em; font-size: 1.6em; line-height: 1.3; } h3 { margin-top: -1.3em; } Tue, 17 Sep 2024 06:00:00 -0500 Home Health /news/headline/2024-09-06-aha-comments-cms-home-health-pps-proposed-rule-cy-2025 <p>The AHA Aug. 26 commented on the Centers for Medicare & Medicaid Services' home health prospective payment system proposed rule for calendar year 2025, expressing <a href="/lettercomment/2024-08-26-aha-comments-calendar-year-2025-home-health-prospective-payment-system-proposed-rule">concerns</a> about ongoing access challenges for beneficiaries needing home health care and the potential for the proposed rule to cause additional disruption. AHA urged CMS to reconsider its proposals and ensure home health agencies receive payment updates reflecting their financial standing to provide high-quality care. Additionally, AHA noted concerns about the proposed rule for long-term care facility Medicare conditions of participation requiring ongoing respiratory virus data reporting. <br> </p> Fri, 06 Sep 2024 13:18:24 -0500 Home Health /lettercomment/2024-08-26-aha-comments-calendar-year-2025-home-health-prospective-payment-system-proposed-rule <p>August 26, 2024</p><p>The Honorable Chiquita Brooks-LaSure<br>Administrator<br>Centers for Medicare & Medicaid Services<br>Attn: CMS-1803-P<br>P.O. Box 8013<br>Baltimore, MD 21244-8013</p><p>Submitted electronically</p><p><em><strong>Re: Medicare Program; Calendar Year (CY) 2025 Home Health Prospective Payment System (HH PPS) Rate Update; HH Quality Reporting Program Requirements; HH Value-Based Purchasing Expanded Model Requirements; Home Intravenous Immune Globulin (IVIG) Items and Services Rate Update; and Other Medicare Policies; 89 Fed. Reg. 55,312 (July 3, 2024).</strong></em></p><p>Dear Administrator Brooks-LaSure:</p><p>On behalf of our nearly 5,000 member hospitals, health systems and other health care organizations, including approximately 1,000 hospital-based home health (HH) agencies, and our clinician partners — more than 270,000 affiliated physicians, 2 million nurses and other caregivers — and the 43,000 health care leaders who belong to our professional membership groups, the ���������� Association (AHA) appreciates the opportunity to comment on the calendar year (CY) 2025 HH prospective payment system (PPS) proposed rule.</p><p><strong>The AHA is very concerned about ongoing access challenges for beneficiaries needing HH care, and the potential for CMS’ proposed updates to lead to further disruption.</strong> HH agencies are vital to Medicare beneficiaries’ recoveries, and they partner with acute care and other hospitals to ensure patients can receive the right care in the most appropriate setting. Hospitals rely on HH agencies for safe and timely discharge of patients and to avoid extended hospital stays. We already see the strain on HH operations — and other post-acute care providers — due to financial challenges, creating ripple effects throughout the continuum of care, including for acute and post-acute hospitals. Despite this, CMS proposes inadequate HH agency payment rate updates and further erroneous behavioral adjustments. <strong>We urge the agency to reconsider these proposals and take steps to ensure HH agencies receive payment updates that match their financial reality and enable them to continue to provide high-quality care to Medicare beneficiaries. </strong></p><p><strong>In addition, the AHA is concerned about the proposed changes for long-term care facility Medicare conditions of participation (CoPs) requiring ongoing respiratory virus data reporting. </strong>We do not believe CoPs are the appropriate lever to impose data reporting requirements, and the proposals are poorly defined.</p><p>We provide additional detail on these issues, as well as other proposals in the rule, below.</p> Mon, 26 Aug 2024 12:20:39 -0500 Home Health /aha-center-health-innovation-market-scan/2024-08-13-4-ways-prep-where-health-care-will-be-delivered-2035 <div class="container"><div class="row"><div class="col-md-8"><p><img src="/sites/default/files/inline-images/4-Ways-to-Prep-for-Where-Health-Care-Will-Be-Delivered-in-2035.jpg" data-entity-uuid="c6eb547b-e1af-44ba-b557-0fbc70b6f189" data-entity-type="file" alt="4 Ways to Prep for Where Health Care Will Be Delivered in 2035. A hospital executive looks through a telescope to see what 2035 has in store for health care." width="100%" height="100%"></p><p>Big changes are coming to health care over the next decade, with technology innovation supporting significant shifts that will necessitate operational changes for providers.</p><p>Technology will continue to get faster, cheaper and smarter. So-called <a href="https://www.graphcore.ai/posts/graphcore-announces-roadmap-to-ultra-intelligence-ai-supercomputer" target="_blank" title="Graphcore: Graphcore Announces Roadmap to Ultra Intelligence AI Supercomputer">“ultra intelligence”</a> artificial intelligence (AI) supercomputers this year are expected to possess four times more parametric capacity than the human brain and be nearly 10 times faster in the number of computations that can be run every second.</p><p>As for how the field will be impacted by the rapidly evolving tech landscape, the consultancy Oliver Wyman recently published an <a href="https://www.oliverwyman.com/our-expertise/insights/2023/dec/fostering-change-in-where-and-how-care-is-delivered.html" target="_blank" title="Oliver Wyman: Fostering Change in Where and How Care Is Delivered">analysis</a> as a follow-up to its <a href="https://www.oliverwyman.com/our-expertise/insights/2023/sep/designing-for-2035.html" target="_blank" title="Oliver Wyman: Designing a Healthcare System for the Next Decade">Designing for 2035 report</a>.</p><h2><span>Forecasting for 2035</span></h2><p>Among the authors’ projections:</p><ul><li><strong>Health care costs will continue to come down</strong> even as workforce expenses and the actionability of data collected remain challenges.</li><li>By 2035, <strong>comprehensive genome sequencing</strong> will be a standard part of medical evaluations, providing insights into an individual’s predisposition to diseases and guiding personalized treatment plans.</li><li><strong>Advanced diagnostic capabilities will expand.</strong> Point-of-care devices and at-home testing kits will provide quick and accurate results for a wide range of conditions, enabling early detection and timely treatment.</li><li>Pharmaceutical companies will <strong>use predictive models to design and test potential drugs</strong> in a matter of days or weeks rather than the years it now takes. Doing a better job of incorporating data into clinical workflows will help ease the burden and burnout that clinicians currently feel from cumbersome technology systems.</li></ul><p>The overall increase in information on outcomes and practice patterns, along with more effective dissemination of data, will enable faster and more accurate treatment decisions. Current struggles with interoperability will be overcome, and data will follow patients in a more efficient manner.</p><h2><span>4 Takeaways for Provider Organizations</span></h2><h3><span>1</span> <span>|</span> Focus on value-added clinical tasks.</h3><p>Some current technological advances already are providing administrative support. Further improvements will come from modifying ChatGPT-like solutions for creating more efficiencies of back-office and other administrative functions. Additionally, AI will support and evolve work completed by nurses, case managers and social workers. Smart implementation of AI systems has the potential to fully automate some tasks, including prior authorizations, care planning and consultations triggered by assessments.</p><h4><span>2035 Outlook</span></h4><p>Keep an eye on robotic medication administration. These systems can identify routine drugs that serve select patients. While these advances significantly will improve everyday efficiency, the rate of adoption will be limited by cost and resource shortages, the report notes. Once this barrier is overcome, hospitals can implement fully baked solutions to optimize operations.</p><h3><span>2</span> <span>|</span> Redistribute care to optimal settings.</h3><p>Hospitals have been important sites of care for two main reasons: economies of scale — reducing the unit cost of care delivery through asset utilization and economies of scope — and using various capabilities and expertise to bend the cost curve and respond to patient variance. But as care delivery has advanced, the impact of economies of scale and scope has diminished. Scale no longer requires being everything to everyone. Likewise, scope needs are lessened through the ability to manage risk and reliance on more precise diagnoses.</p><h4><span>2035 Outlook</span></h4><p>The current inpatient model is capital- and staff-intensive and therefore expensive. It also is not always the safest or most consumer-friendly place to be treated, the report states. Patient preferences and logistics may make being at home the optimal site of care and the authors predict care settings will shift dramatically over the next decade.</p><h3><span>3</span> <span>|</span> Move care from inpatient to outpatient where appropriate.</h3><p>Coming tech advances will lessen the need for inpatient admissions for certain conditions and surgical procedures. Shifts in care protocols, including minimally invasive procedures and improved rehabilitation techniques, will accelerate this transition.</p><h4><span>2035 Outlook</span></h4><p>Expect retail clinic settings to have an impact in this area with their easy accessibility, lower cost structure and a strong focus on preventive care.</p><h3><span>4</span> <span>|</span> Explore moving some inpatient services to home care.</h3><p>The most disruptive transition between now and 2035 could come in this area. The authors project that 64% of inpatient admissions could be moved to the home by 2035, enabled by both improved therapeutics and more effective virtual care.</p><h4><span>2035 Outlook</span></h4><p>At-home care has limitations. Shifting out of an inpatient setting is not feasible for high-risk situations or overly invasive procedures. And not everything that is available to move to the home should, the report states.</p><p>The overall infrastructure still isn’t robust enough to match the potential transition. Only about 40% of U.S. homes were considered to have the most basic aging-ready features, according to a <a href="https://www.census.gov/newsroom/press-releases/2023/aging-ready-homes.html#:~:text=Highlights%3A,aging%2Dready%20homes." target="_blank" title="United States Census Bureau: Census Bureau Releases New Report on Aging-Ready Homes">2023 Census Bureau report</a>, and large areas of rural America, as well as some inner cities, still lack <a href="https://www.census.gov/newsroom/press-releases/2024/computer-internet-use-2021.html" target="_blank" title="United" states census computer and internet use in the united>access to broadband</a>. Still, significant growth could occur in the home care setting.</p></div><div class="col-md-4"><p><a href="/center" title="Visit the AHA Center for Health Innovation landing page."><img src="/sites/default/files/inline-images/logo-aha-innovation-center-color-sm.jpg" data-entity-uuid="7ade6b12-de98-4d0b-965f-a7c99d9463c5" alt="AHA Center for Health Innovation logo" width="721" height="130" data-entity- type="file" class="align-center"></a></p><p><a href="/center/form/innovation-subscription"><img src="/sites/default/files/2019-04/Market_Scan_Call_Out_360x300.png" data-entity-uuid data-entity-type alt width="360" height="300"></a></p></div></div></div>.field_featured_image { position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } .featured-image{ position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } Tue, 13 Aug 2024 06:15:00 -0500 Home Health <div class="container"><div class="row"><div class="col-md-8"><p>On June 26, the Centers for Medicare & Medicaid Services (CMS) issued its calendar year (CY) 2025 <a href="https://www.federalregister.gov/documents/2024/07/03/2024-14254/medicare-program-calendar-year-cy-2025-home-health-prospective-payment-system-hh-pps-rate-update-hh" target="_blank" title="Federal Register: Medicare Program; Calendar Year (CY) 2025 Home Health Prospective Payment System (HH PPS) Rate Update; HH Quality Reporting Program Requirements; HH Value-Based Purchasing Expanded Model Requirements; Home Intravenous Immune Globulin (IVIG) Items and Services Rate Update; and Other Medicare Policies">proposed rule for the home health (HH) prospective payment system (PPS)</a>. Comments are due Aug. 26, and a final rule is expected around Nov. 1. New policies would generally be effective Jan. 1, 2025.</p><div class="panel module-typeC"><div class="panel-heading"><h2>Key Highlights</h2><p>The proposed HH rule would:</p><ul><li>Reduce net HH payments by an estimated 1.7% or $280 million, after all policy changes, compared to estimated CY 2024 payments. This reduction includes:<ul><li>A permanent behavioral adjustment (applied to the 30-day episode payment rate only) that is expected to reduce payments by 3.6%;</li><li>A 3.0% market basket update, reduced by a negative 0.5% productivity adjustment; and</li><li>An estimated 0.6% decrease in payments due to changes in outlier payments.</li></ul></li><li>Require HH agencies to report four new patient assessment items in the HH agency Outcome and Assessment Information Set (OASIS) under the social determinants of health category beginning with CY 2027.</li><li>Add a new standard within the Medicare Conditions of Participation that would require HH agencies to develop, implement and maintain a patient acceptance to service policy that is applied consistently to each prospective patient referred for home health care.</li></ul><p>The proposed rule also contains a provision that would adopt requirements for long term care (LTC) facilities to report certain data elements related to respiratory elements as part of their infection control programs.</p></div></div><h2>AHA Take</h2><p>HH agencies (HHAs) are an important part of the care continuum for Medicare beneficiaries and often are key to enabling hospital partners to safely discharge patients home. CMS’ continued application of such large behavioral adjustments may threaten access to HH care for beneficiaries and, in doing so, also negatively impact care for other patients in need of acute hospital services by preventing hospitals and health systems from discharging patients in a timely manner. The AHA continues to urge CMS to reconsider its approach to these payment reductions to ensure access for patients in need of continued recovery at home.</p><h2>What You Can Do</h2><ul><li>Share this advisory with your senior management team to examine the impact these payment changes would have on your organization in CY 2025.</li><li>Submit a comment letter on the proposed rule to CMS by Aug. 26 explaining the rule’s impact on your patients, staff, facility and local health care partners.</li></ul><h2>Proposed CY 2025 Payment Updates</h2><p>The rule’s proposed net impact is a decrease of 1.7%, or $280 million, in payments after all policy changes, compared to CY 2024. This includes a proposed market basket update of 3.0%, reduced by a statutorily required 0.5% productivity factor ($415 million net increase). CMS’ proposed 4.07% behavioral adjustment (applied to the 30-day payment rate) would reduce payments by an estimated 3.6% overall, or $590 million. In addition, CMS estimates that there would be an 0.6% decrease in overall payments ($100 million) as a result of an updated fixed-dollar loss ratio for outlier payments.</p><p>CMS also provides an estimate of impact by type of HHA. It estimates that freestanding HHAs would see a 1.6% decrease, but facility-based HHAs would receive a 1.9% decrease relative to CY 2024. In addition, HHAs located in rural areas would receive a 0.3% decrease, while those in urban areas are estimated to realize a 1.8% decrease. The difference in rural and urban providers is largely attributable to changes in wage index levels (discussed further in the <a href="/system/files/media/file/2024/07/Regulatory-Advisory-Home-Health-PPS-Proposed-Rule-for-CY-2025.pdf" target="_blank" title="Click here to download the Regulatory Advisory: Home Health PPS Proposed Rule for CY 2025 PDF."><strong>complete regulatory advisory PDF</strong></a>).</p></div><div class="col-md-4"><p><a href="/system/files/media/file/2024/07/Regulatory-Advisory-Home-Health-PPS-Proposed-Rule-for-CY-2025.pdf" target="_blank" title="Click here to download the Regulatory Advisory: Home Health PPS Proposed Rule for CY 2025 PDF."><img src="/sites/default/files/inline-images/Page-1-Regulatory-Advisory-Home-Health-PPS-Proposed-Rule-for-CY-2025-20240723.png" data-entity-uuid="73fbb8b0-d9d9-4021-a49a-f9ed38f67614" data-entity-type="file" alt="Regulatory Advisory: Home Health PPS Proposed Rule for CY 2025 page 1." width="695" height="900"></a></p></div></div></div> Mon, 22 Jul 2024 11:50:22 -0500 Home Health /aha-center-health-innovation-market-scan/2024-07-02-4-takeaways-coming-shift-health-services-demand <div class="container"><div class="row"><div class="col-md-8"><p><img src="/sites/default/files/inline-images/4-Takeaways-on-Coming-Shift-in-Health-Services-Demand.png" data-entity-uuid="cc5ff1a8-a784-4924-96b8-17d95e977efd" data-entity-type="file" alt="4 Takeaways on Coming Shift in Health Services Demand. A business man stands on a raised path that forks into three arrows pointing in different directions." width="100%" height="100%"></p><p>The coming decade will present significant challenges for hospitals and health systems as they strive to meet a shifting demand for services.</p><p>Rising volumes will require a greater focus on managing patient flow and reducing emergency department (ED) bottlenecks as providers seek to reduce wait times for those needing beds.</p><p>The evolving landscape will be led by an aging population, increased incidence of chronic disease and a higher demand for mental health services — all of which will cause inpatient and outpatient volumes to rise, notes the <a href="https://vizientinc-delivery.sitecorecontenthub.cloud/api/public/content/47212a11b76244d2b3bc7f0e0db086e5" target="_blank" title="Sg2: 2024 Impact of Change® Forecast Highlights">Sg2 2024 Impact of Change report</a>.</p><p>The report’s disease-based forecasting model analyzes patient-level data across service lines and sites of care for more than 27,000 unique disease and procedure combinations, helping organizations understand their care delivery opportunities in the decade ahead.</p><h2><span>Assessing Inpatient and Outpatient Volumes</span></h2><p>Inpatient utilization can be expected to rise 3% to 31 million annual discharges while inpatient days will increase 9% to 170 million, the report states. This will impact patient flow in a variety of ways.</p><p>Growth in medical discharges, meanwhile, will outpace surgical discharges as patients age and are increasingly comorbid, exacerbating pressures in the ED to find patient beds.</p><p>Similar trends will impact the outpatient setting, leading to a 17% jump in these volumes to 5.82 billion. Robust growth is forecasted in outpatient surgical services, driven by expanded capabilities and patients’ procedural needs and chronic care required to manage ongoing conditions like dysrhythmia and dementia.</p><h2><span>4 Takeaways on Coming Care Trends</span></h2><h3><span>1</span> <span>|</span> Double down on integrating primary and behavioral health care.</h3><p>Inpatient behavioral health discharges and outpatient volumes are projected to grow 8% and 26%, respectively, over the next decade. This increased demand will place additional pressure on already constrained access points such as primary care and psychotherapy services.</p><h4>Takeaway</h4><p>Data show that up to 75% of primary care visits can include a mental health component, said Stephanie Snider, Sg2 director, in a recent <a href="https://sg2.podbean.com/e/2024-impact-of-change%C2%AE-primary-care/" target="_blank" title="Sg2 Perspectives: 2024 Impact of Change® Primary Care podcast">podcast</a>. This can include everything from disease management that brings stress to a patient to conditions like anxiety, depression or substance use.</p><p>This means providers will need to double down on the progress they have made in integrating primary care, specialty care and behavioral health to identify patient needs at the earliest stage. Offering more co-located spaces for primary care and behavioral health services also could make care more seamless for patients or offering a virtual hub to connect rural and other patients to services.</p><h3><span>2</span> <span>|</span> Target your virtual care services.</h3><p>The shift to virtual care will continue despite adoption headwinds. By 2034, nearly one in four (23%) evaluation and management visits will be delivered in a virtual setting, the report states. Behavioral health virtual visits will see strong growth and make up a larger portion of psychotherapy visits over the next decade, with 50% of psychotherapy visits delivered virtually by 2034.</p><h4>Takeaway</h4><p>Achieving seamless care coordination and verifying that patients can access your virtual care portal easily can help ensure that patients — particularly those with chronic conditions — stay actively engaged in their care. Hospitals typically will see more uptake in virtual services that are consultative in nature — think chronic disease, notes Tori Richie, senior director of intelligence at Sg2. Surgical-related services, such as orthopedic or spinal conditions, will have less virtual uptake.</p><h3><span>3</span> <span>|</span> Hone your home care strategies.</h3><p>Further enabled by virtual capabilities, home health is expected to grow 22%. As the aging, high-acuity patient population continues to require longer stays in the hospital (with 9% inpatient growth forecast), organizations must be intentional about how they plan their inpatient and outpatient service-line strategies, the report states.</p><h4>Takeaway</h4><p>Organizations should be asking key questions now to inform their future home-care strategies, Richie suggests. How many bed days could be saved by a robust care-at-home program? Lessons learned in the near term as hospitals and health systems refine their home care offerings as a key component of transitional care and interventions in older patients with chronic diseases will pay dividends in the long term.</p><h3><span>4</span> <span>|</span> Expect a slowdown in bariatric surgeries.</h3><p>A 15% decline in inpatient bariatric surgeries is forecast in the next decade, fueled in part by scaled adoption of pharmaceuticals designed to help patients lose weight and/or reduce blood glucose levels.</p><h4>Takeaway</h4><p>It’s worth noting that an increase of 13% is expected in commercial and self-paid bariatric surgical volumes moving to the outpatient setting.</p></div><div class="col-md-4"><p><a href="/center" title="Visit the AHA Center for Health Innovation landing page."><img src="/sites/default/files/inline-images/logo-aha-innovation-center-color-sm.jpg" data-entity-uuid="7ade6b12-de98-4d0b-965f-a7c99d9463c5" alt="AHA Center for Health Innovation logo" width="721" height="130" data-entity- type="file" class="align-center"></a></p><p><a href="/center/form/innovation-subscription"><img src="/sites/default/files/2019-04/Market_Scan_Call_Out_360x300.png" data-entity-uuid data-entity-type alt width="360" height="300"></a></p></div></div></div>.field_featured_image { position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } .featured-image{ position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } Tue, 02 Jul 2024 06:15:00 -0500 Home Health <div class="container"><div class="row"><div class="col-md-8"><p>The Centers for Medicare & Medicaid Services (CMS) on June 26 issued its calendar year (CY) 2025 proposed rule for the home health (HH) prospective payment system (PPS). This Special Bulletin reviews highlights from this rule. CMS will accept comments on the HH proposed rule through Aug. 26.</p><div class="panel module-typeC"><div class="panel-heading"><h2>Key Highlights</h2><p>The rule would, among other proposals:</p><ul><li>Reduce net HH payments by an estimated $280 million (1.7%) in CY 2025, relative to CY 2024, based upon:<ul><li>A 3.0% market basket increase, reduced by a 0.5% productivity adjustment.</li><li>A 3.6% cut to payments resulting from a behavioral adjustment designed to achieve budget neutrality due to the transition to the Patient-driven Groupings Model (PDGM).</li><li>An adjustment to the fixed-dollar loss ratio for outlier payments that would result in an estimated 0.6% decrease in payments.</li></ul></li><li>Adopt new core-based statistical areas (CBSAs) for purposes of wage indexes.</li><li>Require HH agencies to report four new patient assessment items in the HH agency Outcome and Assessment Information Set (OASIS) under the social determinants of health category beginning with CY 2027.</li><li>Add a new standard within the Medicare Conditions of Participation that would require HH agencies to develop, implement, and maintain a patient acceptance to service policy that is applied consistently to each prospective patient referred for home health care.</li><li>Adopt requirements for long-term care (LTC) facilities to report certain data elements related to respiratory elements as part of their infection control programs.</li></ul></div></div><h2>AHA Take</h2><p>HH agencies are an important part of the care continuum for Medicare beneficiaries and valuable hospital partners allowing for safe and timely discharges to home. The continued application of large behavioral adjustments may very well threaten access to care for beneficiaries and also disrupt operations for other providers, including hospitals. The AHA will continue to urge CMS to reconsider its approach to these payment reductions to ensure access for patients in need of continued recovery at home.</p><p>Highlights from the rule follow.</p></div><div class="col-md-4"><a href="/system/files/media/file/2024/06/cms-releases-cy-2025-home-health-pps-proposed-rule-special-bulletin-6-27-24.pdf" target="_blank"><img src="/sites/default/files/inline-images/cover-cms-releases-cy-2025-home-health-pps-proposed-rule-special-bulletin-6-27-24.png" data-entity-uuid="c518ae6d-038a-45df-b48c-ddacb6626e3f" data-entity-type="file" alt=" Cover Special Bulletin: CMS Releases CY 2025 Home Health PPS Proposed Rule" width="NaN" height="NaN"></a></div></div></div> Thu, 27 Jun 2024 17:08:10 -0500 Home Health /aha-center-health-innovation-market-scan/2024-02-19-special-report-how-health-care-disruptors-will-transform-field <div class="container"> /* center_body */ .center_body { /*margin-top:50px;*/ margin-bottom: 50px; } .center_body h3 {} .center_body p { font-size: 16px } p.center_Intro { color: #002855; line-height: 1.2em; font-size: 30px; margin: 10px 0 25px 0; font-weight: 700; font-size: 2em; } @media (max-width:768px) { p.center_Intro { line-height: 1.2em; font-size: 23px; font-size: 1.45em; } } .center_body .center_Lead { color: #63666A; font-weight: 300; line-height: 1.4; font-size: 21px; } /* center_body // */ <div class="row center_body"><div class="col-md-12"><p class="center_Intro"><a href="/center/form/innovation-subscription">AHA Market Scan</a> special report explores which companies aim to deliver transformational change in 2024.</p></div><div class="col-md-8"><p class="center_Lead">Disruptive competitors surround hospitals and health systems. Many of these competitors are not other hospitals. Today, they are well-financed, long-established retail pharmacies, tech companies, online mega-retailers and payers.</p><p class="center_Lead">These competitors make up a mosaic of familiar names to health care consumers: Amazon, CVS Health, Walgreens, Walmart, UnitedHealth Group/Optum, Microsoft, Google and others. Here’s where these companies have been last year and where they may be headed in 2024.</p>Download the Market Scan Buzz report for a deep dive on what’s ahead for:</p> <ul> <li><a href="/">Amazon</a></li> <li><a href="/">CVS Health</a></li> <li><a href="/">UnitedHealth Group (Optum and UnitedHealthcare)</a></li> <li><a href="/">Walgreens Boots Alliance</a></li> <li><a href="/">Walmart</a></li> <li><a href="/">Apple</a></li> <li><a href="/">Google</a></li> </ul>--> .center_callout_3ul{ margin-top:50px; background-color:#b9d9eb66; margin-bottom:25px; } .center_callout_3ul h3{ font-size: 30px; } .center_callout_3ul ul { list-style: none; /* Remove default bullets */ padding-left: 30px; margin-top:15px; margin-bottom: 25px; padding-right:15px; } .center_callout_3ul ul li { margin-bottom: 7px; line-height: 1.5em; padding-left: 23px; text-indent: -23px; font-size:16px; } .center_callout_3ul ul li::before { content: " "; font-size: 1em; margin-right: 5px; display: inline-block; height: 12px; background-color: #d50032; width: 12px; position: relative; top: 0px; } .center_callout_3ul ul li h3{ display:inline-block; display: initial; top: 4px; position: relative; left: 15px; font-size:23px; } <div class="container-fluid col-sm-10 col-sm-offset-1 center_callout_3ul"><h2>Deep Dive On What’s Ahead For:</h2><ul><li><h3><a href="/system/files/media/file/2024/02/2024-Health-Care-Disruption-Outlook.pdf#page=3" target="_blank">Amazon</a></h3></li><li><h3><a href="/system/files/media/file/2024/02/2024-Health-Care-Disruption-Outlook.pdf#page=4" target="_blank">CVS Health</a></h3></li><li><h3><a href="/system/files/media/file/2024/02/2024-Health-Care-Disruption-Outlook.pdf#page=5" target="_blank">UnitedHealth Group/Optum</a></h3></li><li><h3><a href="/system/files/media/file/2024/02/2024-Health-Care-Disruption-Outlook.pdf#page=6" target="_blank">Walgreens Boots Alliance</a></h3></li><li><h3><a href="/system/files/media/file/2024/02/2024-Health-Care-Disruption-Outlook.pdf#page=7" target="_blank">Walmart</a></h3></li><li><h3><a href="/system/files/media/file/2024/02/2024-Health-Care-Disruption-Outlook.pdf#page=9" target="_blank">Google Health</a></h3></li><li><h3><a href="/system/files/media/file/2024/02/2024-Health-Care-Disruption-Outlook.pdf#page=10" target="_blank">Microsoft</a></h3></li></ul></div></div><div class="col-md-4 col-sm-12"><a href="/system/files/media/file/2024/02/2024-Health-Care-Disruption-Outlook.pdf" title="Download, Special Report: 2024 Health Care Disruption Outlook" target="_blank"><img src="/sites/default/files/2024-02/2024_Disruption_Report_cover_700x541.jpg" alt="Special Report: 2024 Health Care Disruption Outlook" width="100%"></a><p><br><a class="btn btn-primary" href="/system/files/media/file/2024/02/2024-Health-Care-Disruption-Outlook.pdf" target="_blank" title="Download, Special Report: 2024 Health Care Disruption Outlook" rel="noopener nofollow">Download the Special Report: 2024 Health Care Disruption Outlook</a></p><div><a href="/center/form/innovation-subscription" title="Weekly Email Updates: Stay in the loop with Market Scan - Subscribe Today"><img src="/sites/default/files/2019-04/Market_Scan_Call_Out_360x300.png" alt="Weekly Email Updates: Stay in the loop with Market Scan - Subscribe Today"> </a></div></div></div><div class="row y-sections"><div class="col-md-12"><h2>More Market Scan Articles</h2></div> .y-sections{ margin-top:50px; } .y-sections .y-padding { padding: 10px; margin: 15px 0; } .y-sections h2:nth-child(1) { text-align: left; margin: 0px; } .y-sections h4 { color: #9d2235; font-size: ; } .y-padding img { -webkit-box-shadow: -13px 13px 10px -7px rgba(99, 102, 106, 0.66); -moz-box-shadow: -13px 13px 10px -7px rgba(99, 102, 106, 0.66); box-shadow: -13px 13px 10px -7px rgba(99, 102, 106, 0.66); } .y-lock::before { background: url("/sites/default/files/2018-11/lock-img.gif") no-repeat top left; background-size: 20px 20px; display: inline-block; content: ""; width: 20px; height: 20px; position: relative; top: 0px; left: 0px; margin-right: 10px; } .y-nolock { padding: 4px; } .y-resources { margin: 25px 0; padding-bottom: 15px; } .y-resources h4 { color: #9d2235; font-size: ; } .y-resources h4 span { color: #003087; } .bootnon-margin { padding: 0px !important; } .y-resources a.y-link { color: #9d2235; font-weight: 700; } .y-resources img { border-radius: 50%; } <div class="row y-sections"><div class="col-md-3"><div class="y-padding"><a href="/aha-center-health-innovation-market-scan/2024-01-23-7-innovative-devices-ces-2024-could-reshape-patient-self-care" target="_blank"><img src="/sites/default/files/2024-02/2024_CES_Conference-700x532.jpg" alt="xxxxxxxxxx"></a><h3><a href="/aha-center-health-innovation-market-scan/2024-01-23-7-innovative-devices-ces-2024-could-reshape-patient-self-care" target="_blank">7 innovative devices from CES 2024 could reshape patient self-care</a></h3><p>The recent CES 2024 show (formerly the Consumer Electronics Show) produced a number of health care-related, attention-getting devices.</p></div></div><div class="col-md-3"><div class="y-padding"><a href="/aha-center-health-innovation-market-scan/2024-01-16-takeaways-3-big-disruptors-jpm-healthcare-2024" target="_blank"><img src="/sites/default/files/2024-02/2024_JPM_Conference700x532.jpg" alt="xxxxxxxxxx"></a><h3><a href="/aha-center-health-innovation-market-scan/2024-01-16-takeaways-3-big-disruptors-jpm-healthcare-2024" target="_blank">Takeaways from 3 big disruptors at JPM Healthcare 2024</a></h3><p>Health care executives, retail health providers and investors came together recently to share insights and outlooks at the 2024 J.P. Morgan Healthcare Conference.</p></div></div><div class="col-md-3"><div class="y-padding"><a href="/aha-center-health-innovation-market-scan/2023-11-21-amazons-one-medical-ramps-its-expansion-primary-care" target="_blank"><img src="/sites/default/files/2024-02/Amazon_OneMedical_opening-700x532.jpg" alt="xxxxxxxxxx"></a><h3><a href="/aha-center-health-innovation-market-scan/2023-11-21-amazons-one-medical-ramps-its-expansion-primary-care" target="_blank">Amazon’s One Medical ramps up its expansion in primary care</a></h3><p>Amazon’s One Medical membership-based primary care unit provides on-demand 24/7 access to telehealth services and in-person care continues to report growth.</p></div></div><div class="col-md-3"><div class="y-padding"><a href="/aha-center-health-innovation-market-scan/2023-11-07-vha-shark-tank-competition-generates-innovative-health-care-solutions" target="_blank"><img src="/sites/default/files/2024-02/VA_Shark_Tank3-700x532.jpg" alt="xxxxxxxxxx"></a><h3><a href="/aha-center-health-innovation-market-scan/2023-11-07-vha-shark-tank-competition-generates-innovative-health-care-solutions" target="_blank">VHA Shark Tank Competition generates innovative health care solutions</a></h3><p>Improving response to sepsis, reducing ED visits, standardizing communication in the OR and streamlining patient alerts were among the winners.</p></div></div></div></div></div> Tue, 20 Feb 2024 06:15:00 -0600 Home Health