In the News

Home Health, Hospice Leadership Lays Out 2025 Priorities

Home Care Magazine | By Hannah Wolfson

Stopping Medicare cuts, ensuring Medicare Advantage beneficiaries have good access to care, passing groundbreaking hospice legislation and bringing homecare into the forefront are all priorities for the newly-formed National Alliance for Care at Home, said CEO Steve Landers.

“We’ve got to start improving access to home health care, and the way that we do that is we end this march of payment cuts that are being set forward by Medicare,” Landers said at the Alliance’s Homecare and Hospice Conference and Expo, which was held in October in Tampa, Florida.

The event was originally organized by the National Association for Homecare and Hospice (NAHC), which merged this summer with the National Hospice and Palliative Care Organization (NHPCO) to form the new group. The expo included a handoff from NAHC President Bill Dombi to Landers.

The new organization plans to highlight the patient and family perspective to advocate for home health in Washington and beyond, which Landers called a “life or death issue.”
Landers said the new alliance has the opportunity to have a stronger voice, and that he will add his own clinical perspective to his leadership and conversations with regulators and legislators.

“I'm also a family caregiver and have my own personal experiences with homecare and hospice that have instructed how I think about these things,” Landers said. “There is every opportunity here to get stronger, to try to make a bigger impact. … We need to find another way to tell these stories, to somehow get somebody to listen.”

This will require getting frontline workers, patients and their families into the offices of decision-makers to tell their stories, Landers said. It may entail additional partnerships with state associations to focus on local advocacy, as well as sharing data from studies that show the positive outcomes in-home care has on patients’ lives.

The alliance has automatically enrolled members of both legacy organizations, but Landers said that for renewals or new members, participants will be required to sign an attestation that says they have a program in place for quality and compliance, that they monitor the Office of Inspector General’s expulsion list and don’t take referrals or staff from organizations on that list and that they strive to participate in Medicare’s quality reporting programs.

“In order to make a difference on behalf of our members and make a difference on behalf of the people that need care at home, we have to have as credible and high integrity of a voice as possible,” Landers said.

Landers spoke before the results of the election were known or the final rule on home health payments was released by the Centers for Medicare and Medicaid Services. But even then, he said it would be important for advocates and providers to work for the long haul.

“We've got to wake ourselves up … and just keep our energy up, keep our voices up," he said. "So many people are depending on us, and they're hidden. The people that depend on home health and hospice care programs—they're hidden. They're sick, they're in their homes, mostly. Their families are stressed. … We’ve got to keep the volume up and keep telling the story.”…

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As Home Health Providers Dive Into AI, Study Examines Its Effect On Reducing Documentation Time

Home Health Care News / By Audrie Martin

Artificial intelligence-powered documentation does not enhance clinician efficiency but may improve their work-life balance, according to a study published in the New England Journal of Medicine.

Researchers at Atrium Health in Charlotte, North Carolina, and the Wake Forest University School of Medicine conducted a study in mid-2023 comparing 112 primary care clinicians who used Nuance’s Dragon Ambient eXperience (DAX) Copilot clinical documentation software with a control group of 103 clinicians who did not use the tool.

DAX Copilot is an AI-enabled scribe software integrated with electronic health records (EHR). It creates a preliminary clinical note by “listening” to the conversation between a clinician and a patient during their visit.

The purpose of this tool is to reduce administrative burdens, allowing clinicians to concentrate more on patient care. In doing so, AI-powered clinical documentation tools could help mitigate physician burnout and enhance the efficiency of health care delivery.

Home health providers are hoping AI tools can do the same for their nurses.

At the beginning of the day, clinicians log into the EHR and open DAX through a link. Before entering a patient’s room, they launch the smartphone application and begin recording while still outside the room to capture the patient’s name, reason for the visit and other relevant information.

Once the visit concludes, the clinician stops the recording, and the application generates the preliminary note within 30 seconds. The draft is available for review either in the smartphone app or in a preview window on the computer. Both options allow the clinician to edit the note. However, research indicates that most clinicians do not use this editing feature. Typically, they transfer the note to the EHR using voice commands or the “copy” button and make further edits within the EHR before finalizing the note.

The primary outcomes of EHR usage and its financial impact were evaluated over 180 days. The DAX group divided participants into two subgroups: active users and high users. Active users transferred approximately 25% of DAX notes, while high users transferred around 60%.

Exploratory analyses indicated that high DAX usage could lead to small reductions in documentation hours, mainly when implemented with low-volume clinicians and in family medicine practices.

“In this evaluation, we found no statistically significant differences in EHR-related and financial metrics between DAX users and the control group,” the researchers wrote. “However, exploratory results suggested that modest reductions in documentation time could occur when using DAX at a high utilization level or when targeting specific clinical subgroups. Overall, these findings imply that the efficiencies gained from AI-enhanced documentation may reduce burnout indicators for a subset of clinicians and potentially on a broader scale if DAX is adopted widely. However, implementing DAX in its current form will unlikely lead to substantial productivity gains for health care systems.”

Users agree AI aids work-life balance

While researchers couldn’t identify significant improvements in documentation or financial metrics, a subset of clinicians noted that the tool saved them time. Instead of seeing more patients, this extra time allowed them to get more sleep, reduce their work hours at home, and personalize and focus on existing patient encounters. These changes may contribute to better patient outcomes and greater satisfaction, not to mention better work-life balance.

To that end, Kathy Hoffman, chief clinical officer at Pinnacle Home Care, told Home Health Care News earlier this year that using an AI-powered language model has helped streamline operations, saving time on documentation and giving clinicians more downtime at home…

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CMS Approves Revised Home Health Change of Care Notice

Alliance Daily

The Office of Management and Budget (OMB) has approved the Home Health Change of Care Notice (HHCCN) for 3 years. There were no substantive changes made to the HHCCN form or the form instructions. CMS did make plain language and information design changes to the form and form instructions according to our Office of Communications (OC) recommendations. OC’s recommendations in plain language and information design are research-based best practices. The OC worked to apply the same research-based standards across all products and channels to make sure our language, messaging and branding are consistent.

CMS has also provided the HHCCN in 3 additional languages with this package approval. Those languages, along with English and Spanish, include Chinese, Vietnamese and Korean.

Since the current HHCCN does not expire until 12/31/2024, you may continue to use the HHCCN (OMB expiration date of 12/31/2024) until 1/31/2025 however, you will be required to use the newly approved HHCCN (OMB expiration date of 11/30/2027) on 2/1/2025. The newly OMB approved HHCCN form (expiration date of 11/30/2027) may be found in the downloads section. FFS HHCCN | CMS

Hidden Changes: What Home Health Providers May Have Missed In The Final Rule

Home Health Care News / By Audrie Martin

On Nov. 1, the Centers for Medicare & Medicaid Services (CMS) issued the final home health payment rule for 2025, updating Medicare policies and rates for home health agencies.

But while the payment-related information grabbed headlines, there are plenty of other changes to home health care within the rule that providers should be paying attention to.
CMS estimated that Medicare payments to agencies in 2025 would increase by 0.5%, or $85 million, compared to 2024. In addition to the slight payment increase, the rule introduced other changes for HHAs that may impact their business practices.

“This is not where we want to be,” William A. Dombi, president emeritus of the National Alliance for Care at Home, said during a recent webinar. “We are on a slippery slope toward potential disaster. We projected this would happen when we examined CMS’ methodology for budget neutrality. All CMS has done is mitigate the situation, rather than create a foundation for restoring the home health benefit to its intended state.”

Elara Caring CEO Scott Powers echoed this sentiment and urged CMS to reevaluate its payment model.

“While CMS’ 2025 payment adjustments attempt to address some challenges faced by home health providers, the current approach remains inadequate,” Powers told Home Health Care News. “The budget neutrality methodology continues to undermine the fundamental purpose of home health care, limiting access for the seniors who rely on these services the most. We urge CMS to prioritize a payment model that genuinely reflects the value of home health care.”

With a presence in 18 states, Elara Caring provides an array of home-based care services across more than 200 locations, serving more than 60,000 patients.

“CMS’ decision to implement a -1.975% permanent projected adjustment to home health payments is deeply concerning,” Compassus CEO Mike Asselta told HHCN. “This is particularly troubling as the demand for these services continues to rise. Concurrently, new conditions of participation increase the administrative burdens on home health agencies without adequately addressing critical issues like access to care.”

Based in Brentwood, Tennessee, Compassus also offers a wide range of home-based care services including home health care, home infusion, palliative care, hospice care and home-based high-acuity care, with more than 270 locations across 30 states.

Bud Langham, the executive vice president of clinical excellence and strategy for Enhabit Inc. (NYSE: EHAB) , expressed significant concern about the 2025 home health final rule.
“The most pressing issue is yet another cut to home health reimbursement,” he said. “This marks the third consecutive implementation of negative permanent adjustments, along with planned temporary adjustments that are still pending. Congress needs to take action; over 60 million Medicare-eligible Americans are counting on it.”

In addition to the disappointing annual payment update, CMS has finalized several other changes that will affect home health providers starting in 2025 and beyond…

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Home Health 2025 Outlook Webinar

January 8 at 10 a.m. MT

The year ahead is likely going to be another exciting one for home health providers, fraught with challenges and filled with opportunity. They’ll have to consider how to mitigate fee-for-service rate cuts, and also how they will win better contracts with Medicare Advantage plans. Another consideration is how to find ways to grow with staffing constraints, and also hit the right chords with technology adoption.

The home health landscape changes every year. Prepare for 2025 with this webinar, as we are joined by top minds from the industry.

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