The HHVBP Changes Experts Believe Home Health Providers Are ‘Overlooking’

Home Health Care News | By Patrick Filbin
 
Several of the biggest changes in the U.S. Centers for Medicare & Medicaid Services’ (CMS) CY 2024 final home health rule deal with the Home Health Value-Based Purchasing (HHVBP) model.
 
At face value, it may seem like the HHVBP process is being simplified in the way providers fill out OASIS forms.
 
However, there’s more to it than just that.
 
“What is true today is not what’s going to be true with the final rule,” Cindy Krafft, owner of K&K Health Care Solutions, said during a MedBridge webinar on Tuesday. “I do believe that many people were so concerned about the reimbursement piece that there was not enough feedback in the open comment period about some of these other things.”
 
For instance, Krafft pointed out the HHVBP change which saw a total normative composite turn to a discharge functional score.
 
Essentially, CMS will evaluate home health agencies with an emphasis on the functional status of patients at the time of discharge from their agencies, as opposed to a comprehensive measure of various factors — including patient outcomes, processes of care and patient experience.
 
“That sounds like a great concept, but we can’t oversimplify it,” Krafft said.
 
For example, OASIS measures like eating, oral hygiene, toileting hygiene and a number of physical functionality scores are included in the new calculation.
 
What’s missing, Krafft pointed out, is bathing and dressing.
 
“There are some pretty heavy-hitting activities related to function that we have been focused on — and rightfully so — for a very long time,” Krafft said. “Even before OASIS, we knew our folks had to be able to manage bathing and dressing and meal prep and all of those things to be able to have patients be safe at home. But they’re not on this list.”
 
The reason why the list is shortened is related to the Improving Medicare Post-Acute Care Transformation Act, also known as the IMPACT Act.

Read Full Article

Not All Exercise Is Beneficial: The Physical Activity Paradox Explained 

Medscape | By Marilynn Larkin

In the pursuit of optimal health, regular physical activity (PA) is recommended to protect against dementia, cardiovascular disease (CVD), cancer, and other noncommunicable diseases. A significant body of research suggests the benefits of PA are positively correlated with higher frequency and intensity — with more often deemed better. This research has spawned a focus on increasing step counts and investing in standing desks and other interventions aimed at keeping people active.

But for many people, PA is a work requirement over which they have little control, and emerging evidence suggests that these workers not only do not reap the benefits associated with leisure-time PA, but they also actually experience an increased risk for the very conditions that PA is intended to prevent.

A study published recently in The Lancet Regional Health – Europe used registry data from more than 7000 adults in Norway, following them from age 33 to 65 years, to assess PA trajectories and risks for later-life mild cognitive impairment (MCI) and dementia at age 70 or older.

Read Full Article

New Tests May Finally Diagnose Long COVID

Medscape | By Sara Novak

One of the biggest challenges facing clinicians who treat long COVID is a lack of consensus when it comes to recognizing and diagnosing the condition. But a new study suggests testing for certain biomarkers may identify long COVID with accuracy approaching 80%. 

Effective diagnostic testing would be a game-changer in the long COVID fight, for it’s not just the fatigue, brain fog, heart palpitations, and other persistent symptoms that affect patients. Two out of three people with long COVID also suffer mental health challenges like depression and anxiety. Some patients say their symptoms are not taken seriously by their doctors. And as many as 12% of long COVID patients are unemployed because of the severity of their illness and their employers may be skeptical of their condition.

Quick, accurate diagnosis would eliminate all that. Now a new preprint study suggests that the elevation of certain immune system proteins are a commonality in long COVID patients and identifying them may be an accurate way to diagnose the condition.

Researchers at Cardiff University School of Medicine in Cardiff, Wales, United Kingdom, tracked 166 patients, 79 of whom had been diagnosed with long COVID and 87 who had not. All participants had recovered from a severe bout of acute COVID-19.

In an analysis of the blood plasma of the study participants, researchers found elevated levels of certain components. Four proteins in particular — Ba, iC3b, C5a, and TCC — predicted the presence of long COVID with 78.5% accuracy.

"I was gobsmacked by the results. We’re seeing a massive dysregulation in those four biomarkers," says study author Wioleta Zelek, PhD, a research fellow at Cardiff University. "It’s a combination that we showed was predictive of long COVID." 

The study revealed that long COVID was associated with inflammation of the immune system causing these complement proteins to remain dysregulated. Proteins like C3, C4, and C5 are important parts of the immune system because they recruit phagocytes, cells that attack and engulf bacteria and viruses at the site of infection to destroy pathogens like SARS-coV-2. 

In the case of long COVID, these proteins remain chronically elevated. While the symptoms of long COVID have seemed largely unrelated to one another, researchers point to elevated inflammation as a connecting factor that causes various systems in the body to go haywire.

Read Full Article

ICYMI: Second Round of Ordering for Free COVID-19 Tests Now Open

ACL Updates

Starting on September 25, every U.S. household had an opportunity to order four free at-home COVID-19 tests through a partnership between the HHS Administration for Strategic Preparedness and Response and the United States Postal Service.

On November 20, a second round of ordering opened, allowing each household to place a second order to receive four more free tests. Households that have not yet placed an order can place two orders now, to receive a total of eight tests.

To order your free tests, go to COVID.gov and complete the form with your contact and shipping information.

People who are blind or have low vision can place a second order for free Ellume COVID Home Tests, which are more accessible than other options. For more information, including ordering instructions, please visit ACL's website.