Health Economics Program
|
|
- Alexandra Davis
- 5 years ago
- Views:
Transcription
1 Health Economics Program Issue Paper July 2000 Home Care Provider Trends in Minnesota: Background Minnesota has an interesting history with regard to home care trends. Although Medicare beneficiaries in Minnesota have better access to Medicare-covered home health services (measured by the number of Medicare certified home health agencies per elderly person) than beneficiaries in most of the rest of the country, Medicare picks up less of the home health bill in Minnesota than in other states. 1 This reflects the combined effects of fewer Medicare beneficiaries receiving home health benefits and those that do receive benefits getting fewer visits. Specifically, in 1992, Minnesota ranked 48th in the proportion of Medicare beneficiaries receiving home health benefits and, in 1994, ranked 50th in the number of home health visits per person served. In 1996, the State Legislature responded to this by mandating the Medicare Maximization Initiative which hopes to maximize Medicare payments for home care and hospice services by ensuring that, when appropriate, Medicare pays for these services. By 1997, Minnesota had risen in the ranks to 38th in home health visits per person served. Through Medical Assistance home health and personal care benefits, as well as home and communitybased services waivers, Minnesota has sought to expand options in the community for low-income persons. Indeed, the growth in spending in this area has averaged 6.6% over the last four years, when all other Medical Assistance service areas have declined. 2 Even with this growth, the results are somewhat marginal with only a small fraction less than 8 percent of Medical Assistance long-term care expenditures for the elderly going towards home and community-based care. Understanding home care provider trends in the State is important for a number of reasons. First, there has always been a general concern that the quality of and access to home care be adequate. Second, at the same time the State is trying to maximize Medicare reimbursement, the U.S. Congress passed reimbursement and coverage policy changes to reign in Medicare home care spending. How these dynamics effect the capacity to deliver high quality care to those who need it is something policymakers and other stakeholders should understand. Finally, the strong economy has produced a state-wide staffing crisis over the last couple years for which the impact on home care providers is uncertain and may be hard to separate from other effects. The purpose of this Issue Paper is to discuss home care provider trends for the period of 1994 to 1999 with an eye towards these kinds of policy questions. This is done using data from the Minnesota Department of Health s Facility and Provider Compliance Division. Types of licensed home care providers To deliver health-related or supportive services to persons in their homes, providers must be licensed by the Minnesota Department of Health. There are seven different categories of home care licensure in Minnesota Department of Health
2 Minnesota which vary by type of service provided and whether these services are provided in individual homes or housing-with-services settings. (See the box on page 2.) They are: professional home care agency (a subset of which are also Medicare certified home health agencies), paraprofessional agency, individual paraprofessional, hospice, assisted living program, home management services, and assisted living home care providers. Table 1 provides an overview of the services and settings for various licensed home care entities. Types of licensed home care providers Class A (Professional home care agency): A traditional home health agency that serves the community as well as housing with services (HWS) settings. A subset of Class A providers are also Medicare certified. They also may provide professional nursing services, therapies, nutritional services, medical social services, home health aide tasks, and provide medical supplies and equipment when accompanied by the provision of home care service. Class B (Paraprofessional agency): The Class B paraprofessional agency serves both the community and HWS settings. They may provide home care aide tasks (stand-by assistance with dressing, grooming and bathing, reminders, housekeeping), and home management tasks, but no delegated nursing services. Class C (Individual paraprofessional): Individual paraprofessionals provide services in the community and in HWS settings. They may provide home health aide tasks (e.g. routine delegated medical or nursing services, assigned therapy services, administration of medications), home care aide tasks, and home management tasks. Class D (Hospice): Under this license, a provider may provide hospice services in the home. Class E (Assisted living program): These providers can only serve clients in HWS settings or residential centers. They may provide home care aide tasks or home management tasks. The services can be provided by the assisted living management or under a contract with that management. Class M (Home management services): A certificate of registration for home management can be obtained if the services provided include at least two of the following: housekeeping, meal, preparation, and shopping, and are provided to a person who is unable to perform these activities due to illness, disability or physical condition. Assisted Living Home Care Provider: These providers can only serve clients in HWS settings, may provide professional services, home health aide tasks (e.g. delegated nursing services), home care aide tasks, and central storage of medicine.* *The Assisted Living Home Care Provider category was effective August 1999; consequently, they do not appear in the trends presented here. Table 1: Overview of services and settings for certain licensed home care providers 2
3 Figure 1 shows that, in 1999, about two-thirds of home care providers were licensed as Class A (certified home health agencies and other professional home care agencies). Over half of these were certified by Medicare. Individual paraprofessionals (or Class C) represent the second largest type of licensed home care provider, followed closely by hospice providers. Table 2: Licensed home care providers in Minnesota: Figure 1 Licensed home care providers by type, 1999 State-wide trends The total number of licensed home care providers has grown from 587 in 1994 to 679 in 1999 an average annual change of 2.5 percent (Table 2). Consistent, steady growth has been seen among professional, hospice and home management providers. The number of Class E (assisted living) providers increased quickly in the early part of the period, and then declined rapidly later. As expected, the most erratic patterns are among individual paraprofessional, where year-to-year changes are significant despite the fact that change over the five-year period was relatively small. There are a number of possible shortcomings that may exist with the data presented in Table 2. First, the table shows state-wide information and might obscure regional, urban/rural or other market differences. Second, because these are net numbers, it is possible that from year to year there is more volatility than these number show. For example, between 1994 and 1995, the net increase in Medicare certified home health agencies was 22. We can not tell from this data whether 22 new home health agencies opened in Minnesota, or 50 new agencies opened and 28 existing agencies went out of business that year for a net result of 22. Depending on the public policy question one is trying to answer with the data, this may or may not matter. If the public policy question concerns continuity of care, this data may not yield valuable insight. If the question is about overall access to care, it will. The remaining analyses helps to address some of these aggregate data shortcomings. Trends by Economic Development Region To understand regional differences, trends were analyzed by Economic Development Region. Table 3 shows that the 7-county metropolitan area has the 3
4 largest share of licensed home care providers a percentage that actually grew somewhat over the five year time period from 37% to 41%. Two of the thirteen regions (Region 6 and Region11)showed an overall loss in total licensed home care providers. Table 3: Total licensed home care providers in Minnesota: by Economic Development Region interim payment system Recapturing savings from an OBRA 1993 freeze on payment increases Basing payments on location of service rather than location of billing office Clarification of part-time and intermittent nursing care Authority to make payment denials based on normative standards No benefits when drawing blood is the only service provided In Region 6, this was a slow steady decline of providers. In Region 11, the dramatic loss seen between 1994 and 1995 is entirely accounted for by individual paraprofessional providers (Class C). In neither region is the observed loss found among Class A professional licenses or Medicare certified providers. The Balanced Budget Relief Act of 1999 delayed by two years both implementation of the interim payment system (from October 1997 until October 1999) and implementation of the savings from the prospective payment system (from October 1999 until October 2001). However, the coverage changes are already in effect. Table 4 shows that the large anticipated losses in Medicare certified home health agencies have not occurred. Moreover, with these delays, it is unlikely that any major losses, if they happen at all, will be seen before Between 1994 and 1999, only two regions saw any decline in Medicare certified home health agencies and, in both instances, it was by only one agency. More importantly, in no Minnesota county are there fewer than two Medicare certified home health agencies offering services (data not shown) 3 The Balanced Budget Act of 1997 One important public policy question to be considered is how the payment and coverage changes from the Balanced Budget Act of 1997 have effected Medicare certified home health providers. These changes include: Establishing a prospective payment system Reducing per visit cost limits through an 4
5 Table 4: Medicare certified home health agencies in Minnesota: by Economic Development Region Figure 2: Total and Medicare certified home care providers: Rural and urban, Rural Urban Rural vs. Urban Differences Figure 2 shows trends between urban providers (defined as those in a metropolitan statistical area) and rural providers. The most notable difference between urban and rural areas is that a larger proportion (3/4 versus 1/2) of total home care providers in rural areas are Medicare certified home health agencies. Otherwise, the trends of total home care providers and Medicare certified providers track pretty closely in rural and urban areas over the period. Changes in Medicare certified home health agencies Finally, to gain a better understanding of the dynamics of the Medicare certified home health market in both rural and urban areas, Figure 3 shows the gains and losses between 1994 and Total gains outnumber total losses in every period except the most recent one (1998-9). This was true in both rural and urban areas and results in net total gains. Between 1998 and 1999, urban areas gained two Medicare certified home health agencies but lost seven. The five new Medicare certified home health agencies in rural 5
6 areas were exactly offset by the loss of five. Again, with the delays in Medicare payment policy resulting from the Balanced Budget Relief Act of 1999, the effects of the Balanced Budget Act of 1997 are not yet expected. Figure 3 Changes in certified home health agencies: Rural and urban 1Access to Medicare home health services was measured by Medicare certified home health agencies/elderly in 1995, 1996, and Data from: American Association of Retired Persons (1999), Reforming the Health Care System: State Profiles: 1999, Washington, DC: AARP. Wiener, J.M, and Stevenson, D.G. (1998), Long-Term Care for the Elderly: Profiles of Thirteen States, Washington, D.C.: The Urban Institute. American Association of Retired Persons (1996), Reforming the Health Care System: State Profiles: 1996, Washington, DC: AARP. American Association of Retired Persons (1994), Across the States: Profiles of Long-Term Care Systems, Washington, DC: AARP. 2Minnesota Department of Health, Developing a Comprehensive Set of Services to Supplement Medicare: Options for Low-Income Minnesotans, Report to the Legislature, January Unpublished estimates based on Minnesota Department of Health, Facility and Provider Compliance data. Conclusions There are a number of reasons why it is important to understand home care provider trends in the State. As mentioned earlier, quality measured by continuity of care, and access to care are both important considerations for state policymakers. As Minnesota tries to maximize Medicare payments for home care and hospice services and to shift its provision of Medical Assistance long-term care services from institutional settings to community alternatives, it is necessary to understand if the state-wide capacity for these activities exists. This Issue Paper takes the first step in understanding these dynamics. Future analysis should look more carefully at regional trends and work to capture the effects from the delayed Medicare payment changes. The Health Economics Program conducts research and applied policy analysis to monitor changes in the health care marketplace; to understand factors influencing health care cost, quality and access; and to provide technical assistance in the development of state health care policy. For more information, contact the Health Economics Program at (651) This issue brief, as well as other Health Economics Program publications, can be found on our website at: Minnesota Department of Health Health Economics Program 121 East Seventh Place, P.O. Box St. Paul, MN (651) Upon request, this information will be made available in alternative format; for example, large print, Braille, or cassette tape. Printed with a minimum of 30% post-consumer materials. Please recycle.
Dual Eligibles: Medicaid s Role in Filling Medicare s Gaps
I S S U E P A P E R kaiser commission on medicaid and the uninsured March 2004 Dual Eligibles: Medicaid s Role in Filling Medicare s Gaps In 2000, over 7 million people were dual eligibles, low-income
More informationFinal Report No. 101 April Trends in Skilled Nursing Facility and Swing Bed Use in Rural Areas Following the Medicare Modernization Act of 2003
Final Report No. 101 April 2011 Trends in Skilled Nursing Facility and Swing Bed Use in Rural Areas Following the Medicare Modernization Act of 2003 The North Carolina Rural Health Research & Policy Analysis
More informationRevised: November 2005 Regulation of Health and Human Services Facilities
Revised: November 2005 Regulation of Health and Human Services Facilities This guidebook provides an overview of state regulation of residential facilities that provide support services for their residents.
More informationThe Budget: Maximizing Federal Reimbursement For Parolee Mental Health Care Summary
The 2013-14 Budget: Maximizing Federal Reimbursement For Parolee Mental Health Care MAC Taylor Legislative Analyst MAY 6, 2013 Summary Historically, the state has spent tens of millions of dollars annually
More information2017 State of Minnesota Rural Health Report to the Minnesota Legislature, Feb. 2017
2017 State of Minnesota Rural Health Report to the Minnesota Legislature, Feb. 2017 2017 Minnesota Rural Health Association 1 of 22 As rural communities in Minnesota pursue the triple aim of greater access
More informationIntegrated Licensure Background and Recommendations
Integrated Licensure Background and Recommendations Minnesota Department of Health and Minnesota Department of Human Services Report to the Minnesota Legislature 2014 February 2014 Minnesota Department
More informationPlanning Worksheet Identifying EW Customized Living Components
Planning Worksheet Identifying EW Customized Living Components This tool is designed to facilitate discussion between EW lead agencies (counties, managed care organizations and/or tribes) and current or
More informationWorking Paper Series
The Financial Benefits of Critical Access Hospital Conversion for FY 1999 and FY 2000 Converters Working Paper Series Jeffrey Stensland, Ph.D. Project HOPE (and currently MedPAC) Gestur Davidson, Ph.D.
More informationLong Term Care. Lecture for HS200 Nov 14, 2006
Long Term Care Lecture for HS200 Nov 14, 2006 Steven P. Wallace, Ph.D. Professor, Dept. Community Health Sciences, SPH and Associate Director, UCLA Center for Health Policy Research What is long-term care
More informationHealth and Long-Term Care Use Patterns for Ohio s Dual Eligible Population Experiencing Chronic Disability
Health and Long-Term Care Use Patterns for Ohio s Dual Eligible Population Experiencing Chronic Disability Shahla A. Mehdizadeh, Ph.D. 1 Robert A. Applebaum, Ph.D. 2 Gregg Warshaw, M.D. 3 Jane K. Straker,
More informationLong-Term Care Glossary
Long-Term Care Glossary Adjudicated Claim Activities of Daily Living (ADL) A claim that has reached final disposition such that it is either paid or denied. Basic tasks individuals perform in the course
More informationHospital Financial Analysis
Hospital Financial Analysis By David Belk MD The following information is derived mostly from data obtained from three primary sources: The Centers for Medicare and Medicaid Services (CMS) including Medicare
More informationManaged Long-Term Care in New Jersey
Managed Long-Term Care in New Jersey April 2009 Jon S. Corzine Governor Heather Howard Commissioner Introduction New Jersey s Fiscal Year 2009 Budget included the following language: On or before April
More informationDobson DaVanzo & Associates, LLC 440 Maple Avenue East, Suite 203, Vienna, VA
Dobson DaVanzo & Associates, LLC 440 Maple Avenue East, Suite 203, Vienna, VA 22180 703.260.1760 www.dobsondavanzo.com Memorandum Date: September 23, 2011 To: From: William A. Dombi National Association
More informationPiloting Bundled Medicare Payments for Hospital and Post-Hospital Care /
Piloting Bundled Medicare Payments for Hospital and Post-Hospital Care / A Study of Two Conditions Raises Key Policy Design Considerations March 2010 Policymakers are exploring many different models for
More informationHousing with Services
Housing with Services Housing with Services A joint handbook of the Minnesota Board on Aging and the Office of Ombudsman for Long-Term Care 1 Table of Contents Overview of Housing with Services... 1 HWS
More informationAugust 25, Dear Ms. Verma:
Seema Verma Administrator Centers for Medicare & Medicaid Services Hubert H. Humphrey Building 200 Independence Avenue, S.W. Room 445-G Washington, DC 20201 CMS 1686 ANPRM, Medicare Program; Prospective
More informationHOSPICE IN MINNESOTA: A RURAL PROFILE
JUNE 2003 HOSPICE IN MINNESOTA: A RURAL PROFILE Background Numerous national polls have found that when asked, most people would prefer to die in their own homes. 1 Contrary to these wishes, 75 percent
More informationCRS Report for Congress Received through the CRS Web
CRS Report for Congress Received through the CRS Web Order Code RS20386 Updated April 16, 2001 Medicare's Skilled Nursing Facility Benefit Summary Heidi G. Yacker Information Research Specialist Information
More informationAsset Transfer and Nursing Home Use
I S S U E kaiser commission on medicaid and the uninsured November 2005 P A P E R Issue Asset Transfer and Nursing Home Use Medicaid paid for nearly half of the $183 billion spent nationally for long-term
More informationA REVIEW OF NURSING HOME RESIDENT CHARACTERISTICS IN OHIO: TRACKING CHANGES FROM
A REVIEW OF NURSING HOME RESIDENT CHARACTERISTICS IN OHIO: TRACKING CHANGES FROM 1994-2004 Shahla Mehdizadeh Robert Applebaum Scripps Gerontology Center Miami University March 2005 This report was funded
More informationLONG TERM CARE SETTINGS
LONG TERM CARE SETTINGS Long term care facilities assist aged, ill or disabled persons who can no longer live independently. In this section, we will briefly examine the history of long term care facilities
More informationSNAPSHOT Nursing Homes: A System in Crisis
SNAPSHOT 2004 A Crisis in Care The number of Californians age 65 and over is projected to double in the next decade. Many of the facilities slated to provide long-term care for these individuals already
More informationDobson DaVanzo & Associates, LLC 440 Maple Avenue East, Suite 203, Vienna, VA
Dobson DaVanzo & Associates, LLC 440 Maple Avenue East, Suite 203, Vienna, VA 22180 703.260.1760 www.dobsondavanzo.com Memorandum Date: March 25, 2014 To: From: Rose Gonzalez, American Nurses Association
More informationA GUIDE TO HOSPICE SERVICES
A GUIDE TO HOSPICE SERVICES PURPOSE: Minnesota Rules 4664.0140, subpart 1 states: "Every individual applicant for a license, and every person who provides direct care, supervision of direct care, or management
More informationUpdated Physician Practice Acquisition Study: National and Regional Changes in Physician Employment March 2018
Updated Physician Practice Acquisition Study: National and Regional Changes in Physician Employment 2012-2016 March 2018 About the Physicians Advocacy Institute The Physicians Advocacy Institute (PAI)
More informationThe Part-Time Dilemma for Direct Care Workers
MARCH 2018 RESEARCH BRIEF The Part-Time Dilemma for Direct Care Workers BY STEPHEN CAMPBELL Direct care workers need to earn enough to support themselves and their families. While a living wage would help,
More informationMinnesota s Marriage & Family Therapist (MFT) Workforce, 2015
OFFICE OF RURAL HEALTH AND PRIMARY CARE Minnesota s Marriage & Family Therapist (MFT) Workforce, 2015 HIGHLIGHTS FROM THE 2015 MFT WORKFORCE SURVEY i Overall According to the Board of Marriage and Family
More informationHome Health Agency (HHA) Medicare Margins: 2007 to 2011 Issue Brief July 7, 2009
Home Health Agency (HHA) Medicare Margins: 2007 to 2011 Issue Brief July 7, 2009 Dobson DaVanzo & Associates, LLC (www.dobsondavanzo.com) was commissioned by the LHC Group to conduct a margin study for
More informationTrends in Skilled Nursing and Swing-bed Use in Rural Areas,
Trends in Skilled Nursing and Swing-bed Use in Rural Areas, 1996- Working Paper No. 83 WORKING PAPER SERIES North Carolina Rural Health Research and Policy Analysis Center Cecil G. Sheps Center for Health
More informationExecutive Summary and A Vision for Health Care
N AT I O N A L C O M M U N I T Y P H A R M A C I S T S A S S O C I AT I O N Executive Summary and A Vision for Health Care The face of independent pharmacy 2006 NCPA-Pfizer Digest-In-Brief November 2006
More informationThe Opportunities and Challenges of Health Reform
Assessing Federal, State and Market Changes in the Next Decade Medicaid in Alaska Executive Summary, April 2011 Medicaid is a jointly managed federal-state program providing health insurance to low-income
More informationEW Customized Living Contract Planning Worksheet, Part I
Purpose of This Worksheet This planning worksheet is designed to: 1. Delineate component services that can be included in EW customized living and 24 hour customized living packages. 2. Serve as a tool
More informationAppendix A. Laws & Statutory Regulations. K-PASS Self-Direction Toolkit 173
Appendix A Laws & Statutory Regulations K-PASS Self-Direction Toolkit 173 174 K-PASS Self-Direction Toolkit SELF-DIRECTED PERSONAL ASSISTANCE SERVICES 1. 1989 Session of Kansas Legislature Passed H.B.
More informationCalifornia Community Clinics
California Community Clinics A Financial and Operational Profile, 2008 2011 Prepared by Sponsored by Blue Shield of California Foundation and The California HealthCare Foundation TABLE OF CONTENTS Introduction
More informationLong-Term Care in Ohio: A Longitudinal Perspective
Long-Term Care in Ohio: A Longitudinal Perspective Robert Applebaum Shahla Mehdizadeh Scripps Gerontology Center Miami University September 1, 2001 SGC0076 Background A well known principle of today s
More informationSWING BED (SWB) Rural Hospitals under 100 Beds and Critical Access Hospitals
SWING BED (SWB) Rural Hospitals under 100 Beds and Critical Access Hospitals Federal Regulations Hospitals under 100 Beds Critical Access Hospitals CMS State Operations Manual Appendix T Regulations and
More information2014 MASTER PROJECT LIST
Promoting Integrated Care for Dual Eligibles (PRIDE) This project addressed a set of organizational challenges that high performing plans must resolve in order to scale up to serve larger numbers of dual
More informationCOMPREHENSIVE ASSESSMENT AND REVIEW FOR LONG-TERM CARE SERVICES (CARES) FY The 2012 Report to the Legislature
COMPREHENSIVE ASSESSMENT AND REVIEW FOR LONG-TERM CARE SERVICES (CARES) FY 2010-2011 The 2012 Report to the Legislature Table of Contents Executive Summary... ii Introduction... 1 Section I: Assessments
More informationGeiger Gibson / RCHN Community Health Foundation Research Collaborative. Policy Research Brief # 42
Geiger Gibson Program in Community Health Policy Geiger Gibson / RCHN Community Health Foundation Research Collaborative Policy Research Brief # 42 How Has the Affordable Care Act Benefitted Medically
More informationNorth Carolina Innovations Clinical Coverage Policy No: 8-P Amended Date: August 1, 2014
Personal Care Services S5125 Personal Care Services under North Carolina State Medicaid Plan differs in service definition and provider type from the services offered under the waiver. Personal Care Services
More informationEmergency Medical Assistance Report
This document is made available electronically by the Minnesota Legislative Reference Library as part of an ongoing digital archiving project. http://www.leg.state.mn.us/lrl/lrl.asp Emergency Medical Assistance
More informationAnalyst HEALTH AND HEALTH CARE IN SAN JOAQUIN COUNTY REGIONAL
SPRING 2016 HEALTH AND HEALTH CARE IN SAN JOAQUIN COUNTY San Joaquin County Health Care s Rapid Growth Creates Critical Shortages in Key Occupations. Health care has been changing rapidly in the United
More informationFrom Fragmentation to Integration: Bringing Medical Care and HCBS Together. Jessica Briefer French Senior Research Scientist
From Fragmentation to Integration: Bringing Medical Care and HCBS Together Jessica Briefer French Senior Research Scientist 1 Integration: The Holy Grail? An act or instance of combining into an integral
More informationAn Action Plan for Workforce Health and Prevention
An Action Plan for Workforce Health and Prevention There is VALUE in health. There is POWER in prevention. Bringing health and prevention to the workplace is vital for health care reform. 1 Introduction
More informationHealth Law PA News. Governor s Proposed Medicaid Budget for FY A Publication of the Pennsylvania Health Law Project.
Health Law PA News A Publication of the Pennsylvania Health Law Project Volume 21, Number 2 Statewide Helpline: 800-274-3258 Website: www.phlp.org In This Issue Community HealthChoices Update Pennsylvania
More informationHOSPICE POLICY UPDATE
#02-56-13 Bulletin June 24, 2002 Minnesota Department of Human Services # 444 Lafayette Rd. # St. Paul, MN 55155 OF INTEREST TO County Directors Administrative contacts AC, EW, CAC, CADI, TBI DD Waiver
More informationAmerican Health Lawyers Association Institute on Medicare and Medicaid Payment Issues. History of the Physician Fee Schedule
American Health Lawyers Association Institute on Medicare and Medicaid Payment Issues March 20-22, 2013 Baltimore, Maryland Sidney S. Welch, Esq. 1 History of the Physician Fee Schedule Prior to 1992,
More informationMinnesota s Registered Nurse Workforce
Minnesota s Registered Nurse Workforce 2015-2016 HIGHLIGHTS FROM THE 2015-2016 RN WORKFORCE SURVEYi Overall Registered nurses, the largest segment of the health care workforce, deliver primary and specialty
More informationMinnesota Statewide Quality Reporting and Measurement System: Quality Incentive Payment System
Minnesota Statewide Quality Reporting and Measurement System: Quality Incentive Payment System JUNE 2016 HEALTH ECONOMICS PROGRAM Minnesota Statewide Quality Reporting and Measurement System: Quality Incentive
More informationHOMECARE AND HOSPICE REIMBURSEMENT
Hospice Modeling Hospice Changes to Prepare for Medicare Reimbursement and Care Delivery Reform Robert J. Simione Managing Principal Simione Healthcare Consultants, LLC HOMECARE AND HOSPICE REIMBURSEMENT
More informationFebruary 21, Regional Directors Child Nutrition Programs All Regions. State Agency Directors All States
United States Department of Agriculture Food and Nutrition Service 3101 Park Center Drive Alexandria, VA 22302-1500 SUBJECT: TO: February 21, 2003 Implementation of Interim Rule: Monitor Staffing Standards
More informationMedicaid Prescribed Drug Program. Spending Control Initiatives
Medicaid Prescribed Drug Program Spending Control Initiatives For Quarters Ended September 30, 2010 and December 31, 2010 Table of Contents Purpose of Report... 1 Executive Summary... 2 Pharmacy Appropriations
More informationLicensed Nurses in Florida: Trends and Longitudinal Analysis
Licensed Nurses in Florida: 2007-2009 Trends and Longitudinal Analysis March 2009 Addressing Nurse Workforce Issues for the Health of Florida www.flcenterfornursing.org March 2009 2007-2009 Licensure Trends
More informationdual-eligible reform a step toward population health management
FEATURE STORY REPRINT APRIL 2013 Bill Eggbeer Krista Bowers Dudley Morris healthcare financial management association hfma.org dual-eligible reform a step toward population health management By improving
More informationRe: Rewarding Provider Performance: Aligning Incentives in Medicare
September 25, 2006 Institute of Medicine 500 Fifth Street NW Washington DC 20001 Re: Rewarding Provider Performance: Aligning Incentives in Medicare The American College of Physicians (ACP), representing
More informationTHE UTILIZATION OF MEDICAL ASSISTANTS IN CALIFORNIA S LICENSED COMMUNITY CLINICS
THE UTILIZATION OF MEDICAL ASSISTANTS IN CALIFORNIA S LICENSED COMMUNITY CLINICS Tim Bates and Susan Chapman UCSF Center for the Health Professions Overview Medical Assistants (MAs) play a key role as
More informationComplaint Investigations of Minnesota Health Care Facilities
Complaint Investigations of Minnesota Health Care Facilities Report to the Minnesota Legislature explaining the investigative process and summarizing investigations from July 1, 2001 to June 30, 2004 Minnesota
More informationLong Term Care Briefing Virginia Health Care Association August 2009
Long Term Care Briefing Virginia Health Care Association August 2009 2112 West Laburnum Avenue Suite 206 Richmond, Virginia 23227 www.vhca.org The Economic Impact of Virginia Long Term Care Facilities
More informationSection A Identification Information
r Minimum Data Set (MDS) 3.0 Instructor Guide Section A Identification Information Objectives State the intent of Section A Identification Information. Describe the information required to complete Section
More informationApplication for Home Care Licensure General Instructions
Application for Home Care Licensure General Instructions General Instructions This application form should be used by individuals and organizations seeking initial approval to operate as a licensed home
More informationQuality Assurance in Minnesota 2007
Quality Assurance in Minnesota 2007 Findings and Recommendations of the Legislatively- Mandated Quality Assurance Panel Laws of Minnesota 2005, First Special Session, Chapter 4, Article 7, Sec. 57 Final
More informationLong-Term Care Services for the Elderly
INFORMATION BRIEF Research Department Minnesota House of Representatives 600 State Office Building St. Paul, MN 55155 Danyell Punelli, Legislative Analyst 651-296-5058 Updated: January 2017 Long-Term Care
More informationGERIATRIC SERVICES CAPACITY ASSESSMENT DOMAIN 4 ALTERNATE LIVING ARRANGEMENTS
GERIATRIC SERVICES CAPACITY ASSESSMENT DOMAIN 4 ALTERNATE LIVING ARRANGEMENTS Table of Contents Introduction... 2 Purpose... 2 Serving Senior Medicare-Medicaid Enrollees... 2 How to Use This Tool... 2
More information2017 Oncology Insights
Cardinal Health Specialty Solutions 2017 Oncology Insights Views on Reimbursement, Access and Data from Specialty Physicians Nationwide A message from the President Joe DePinto On behalf of our team at
More informationNurturing Care in the Comfort of Home
Nurturing Care in the Comfort of Home Our Mission: Anchor Home Health Care helps individuals maintain a familiar and independent lifestyle by providing the support of nursing and personal care services
More informationNorth Carolina Medicaid and NC Health Choice Transformation Request for Public Input
North Carolina Medicaid and NC Health Choice Transformation Request for Public Input The Department of Health and Human Services is requesting public input from April 25 to 11:59 p.m. on May 25 on Medicaid
More informationPartnering with Public Health Departments in Managed Care. THIS AREA CAN BE LEFT BLANK or ADD A PICTURE
Partnering with Public Health Departments in Managed Care THIS AREA CAN BE LEFT BLANK or ADD A PICTURE 2/3/2017 The Value of Medicaid Managed Care States Have Seen the Value of Medicaid Managed Care 75
More informationSECTION D. Medicaid Programs MEDICAID PROGRAMS
SECTION Medicaid Programs The epartment supports and operates Medicaid programs in partnership with the Agency for Health Care Administration (AHCA), Florida s designated Medicaid agency. Medicaid programs
More informationBulletin. DHS Provides Policy for Certified Community Behavioral Health Clinics TOPIC PURPOSE CONTACT SIGNED TERMINOLOGY NOTICE NUMBER DATE
Bulletin NUMBER 17-51-01 DATE February 27, 2017 OF INTEREST TO County Directors Social Services Supervisors and Staff Case Managers and Care Coordinators Managed Care Organizations Mental Health Providers
More informationTHE IMPACT OF BBA, BIPA and MEDICARE+CHOICE ON LTC (Why Medicare/Medicare Supplement is SHORT-TERM CARE)
THE IMPACT OF BBA, BIPA and MEDICARE+CHOICE ON LTC (Why Medicare/Medicare Supplement is SHORT-TERM CARE) (For a complete description of Medicare, Medicare supplement and Medicare+Choice, see Appendix A
More informationLow-Income Health Program (LIHP) Evaluation Proposal
Low-Income Health Program (LIHP) Evaluation Proposal UCLA Center for Health Policy Research & The California Medicaid Research Institute BACKGROUND In November of 2010, California s Bridge to Reform 1115
More informationhttp://www.bls.gov/oco/ocos077.htm Dietitians and Nutritionists Nature of the Work Training, Other Qualifications, and Advancement Employment Job Outlook Projections Data Earnings OES Data Related Occupations
More informationApplication for Home Care Licensure General Instructions
Application for Home Care Licensure General Instructions General Instructions This application form should be used by individuals and organizations seeking initial approval to operate as a licensed home
More informationSNC BRIEF. Safety Net Clinics of Greater Kansas City EXECUTIVE SUMMARY CHALLENGES FACING SAFETY NET PROVIDERS TOP ISSUES:
EXECUTIVE SUMMARY The Safety Net is a collection of health care providers and institutes that serve the uninsured and underinsured. Safety Net providers come in a variety of forms, including free health
More information2013 Physician Inpatient/ Outpatient Revenue Survey
Physician Inpatient/ Outpatient Revenue Survey A survey showing net annual inpatient and outpatient revenue generated by physicians in various specialties on behalf of their affiliated hospitals Merritt
More informationPolicy Clarification for Caregiver Services and Respite Options for Families of Older Adults
Bulletin December #07-25-08 20, 2007 Minnesota Department of Human Services P.O. Box 64941 St. Paul, MN 55164-0941 OF INTEREST TO County Directors Social Services Supervisors and Staff Health Plans Area
More informationMedicaid and Block Grant Financing Compared
P O L I C Y kaiser commission on medicaid a n d t h e uninsured January 2004 B R I E F Medicaid and Block Grant Financing Compared State and federal budget pressures, rising health care costs, and new
More informationRural Hospital System Growth and Consolidation
Rural Hospital System Growth and Consolidation Issue Brief Rural community-based hospitals have been undergoing significant ownership changes over the past 10 years, with many that had been independently
More informationNational Council on Disability
An independent federal agency making recommendations to the President and Congress to enhance the quality of life for all Americans with disabilities and their families. Analysis and Recommendations for
More informationBenefits Of Hiring A Home Care Agency
Preserving Dignity Through Independence at Home Benefits Of Hiring A Home Care Agency Are you noticing changes in your aging parents that make you concerned about their safety at home? Are they chronically
More informationThe TeleHealth Model THE TELEHEALTH SOLUTION
The Model 1 CareCycle Solutions The Solution Calendar Year 2011 Data Company Overview CareCycle Solutions (CCS) specializes in managing the needs of chronically ill patients through the use of Interventional
More informationLong-Term Care in Michigan: A Survey of Voters Age 45+ Report Prepared by Anita Stowell-Ritter and Susan Silberman
Long-Term Care in Michigan: A Survey of Voters Age 45+ June 2005 Long-Term Care in Michigan: A Survey of Voters Age 45+ Report Prepared by Anita Stowell-Ritter and Susan Silberman Copyright 2005 AARP Knowledge
More informationRural Health Clinics
Rural Health Clinics * An Issue Paper of the National Rural Health Association originally issued in February 1997 This paper summarizes the history of the development and current status of Rural Health
More informationSeeing the Value and Transparency of Medicare Part B: Four Case Studies of Medicare Successes
Seeing the Value and Transparency of Medicare Part B: Four Case Studies of Medicare Successes As the largest payer of healthcare services in the United States, the Centers for Medicare & Medicaid Services
More informationHealth Care Employment, Structure and Trends in Massachusetts
Health Care Employment, Structure and Trends in Massachusetts Chapter 224 Workforce Impact Study Prepared by: Commonwealth Corporation and Center for Labor Markets and Policy, Drexel University Prepared
More informationIndividual Community Living Support (ICLS)
Individual Community Living Support (ICLS) 2017 Assisted Living and Home Care Conference Mike Saindon 4/13/17 ICLS Learning Objectives I. Describe ICLS a. Who can provide? b. Where is ICLS provided? II.
More informationLong-Term Care Community Diversion Pilot Project
Long-Term Care Community Diversion Pilot Project 2009-2010 Legislative Report Rick Scott, Governor Charles T. Corley, Interim Secretary Table of Contents Executive Summary 1 Table 1 - Nursing Home Diversion
More informationLicensing Personal Care Assistance Services - A Report to the 2013 Minnesota Legislature
This document is made available electronically by the Minnesota Legislative Reference Library as part of an ongoing digital archiving project. http://www.leg.state.mn.us/lrl/lrl.asp Licensing Personal
More informationThe State of the Ohio Nonprofit Sector. September Proctor s Linking Mission to Money 471 Highgate Avenue Worthington, OH 43085
The State of the Ohio Nonprofit Sector Proctor s Linking Mission to Money 471 Highgate Avenue Worthington, OH 43085 614-208-5403 allen@linkingmissiontomoney.com www.linkingmissiontomoney.com Table of Contents
More informationRURAL HEALTH RESEARCH POLICY ANALYSIS CENTER. A Primer on the Occupational Mix Adjustment to the. Medicare Hospital Wage Index. Working Paper No.
N C RURAL HEALTH RESEARCH & POLICY ANALYSIS CENTER A Primer on the Occupational Mix to the Medicare Hospital Wage Index Working Paper No. 86 September, 2006 725 MARTIN LUTHER KING JR. BLVD. CB #7590 THE
More informationTelemedicine Reimbursement. An Overview for Oregon
Telemedicine Reimbursement An Overview for Oregon A Brief History - Medicare In 1997 the Balanced Budget Act first authorized Medicare to reimburse for telemedicine services Since 2000 there have been
More informationOverview of the Federal 340B Drug Pricing Program
Overview of the Federal 340B Drug Pricing Program Presented by: James A. Raley, CPA Senior Manager Health Care Services Arnett Carbis Toothman LLP 345 340B Program: Overview Provides discounts on outpatient
More informationLegislative Report. Status of Long-Term Services and Supports
This document is made available electronically by the Minnesota Legislative Reference Library as part of an ongoing digital archiving project. http://www.leg.state.mn.us/lrl/lrl.asp Legislative Report
More informationSchool of Public Health University at Albany, State University of New York
2017 A Profile of New York State Nurse Practitioners, 2017 School of Public Health University at Albany, State University of New York A Profile of New York State Nurse Practitioners, 2017 October 2017
More informationStatus of Long-Term Care in Minnesota 2003
I. Purpose of This Report This report summarizes the status of long-term care 1 for older persons in Minnesota in 2003. It is the first of a required legislative report (M.S. 144A.351) that combines two
More informationParticipant Satisfaction Survey Summary Report Fiscal Year 2012
Participant Satisfaction Survey Summary Report Fiscal Year 2012 Prepared by: SPEC Associates Detroit, Michigan www.specassociates.org Introduction Since 2003, Area Agency on Aging 1-B (AAA 1-B) 1 has been
More informationBACKGROUND PAPER: RURAL AND URBAN DIFFERENCES IN NURSING HOME AND SKILLED NURSING SUPPLY
BACKGROUND PAPER: RURAL AND URBAN DIFFERENCES IN NURSING HOME AND SKILLED NURSING SUPPLY Working Paper No. 74 WORKING PAPER SERIES North Carolina Rural Health Research and Policy Analysis Center Cecil
More informationMedicaid Prospective Payment Update
Medicaid Prospective Payment Update Tom Parker Director of Reimbursement Florida Heath Care Association Lorne Simmons Healthcare Manager Moore Stephens Lovelace CPA s & Advisors 1 Presentation Outline
More informationmedicaid commission on a n d t h e uninsured May 2009 Community Care of North Carolina: Putting Health Reform Ideas into Practice in Medicaid SUMMARY
kaiser commission on medicaid SUMMARY a n d t h e uninsured Community Care of North Carolina: Putting Health Reform Ideas into Practice in Medicaid Why is Community Care of North Carolina (CCNC) of Interest?
More information