‘The Pandemic Is Far from Over’: Top Concerns for the Home Health Industry This Fall

The home health industry entered the eighth month of the COVID-19 pandemic this October. While most have adapted to a “new normal,” the public health emergency — and a possible second wave — understandably remains the biggest concern for many operators across the country.

As of Oct. 1, there had been more than 7 million COVID-19 cases in the U.S. with more than 200,000 deaths, according to federal statistics. A forecasting model created by the Institute for Health Metrics and Evaluation at the University of Washington estimates that there will be 371,509 COVID-19 deaths by January 2021.

To get a better understanding of what home health operators are up against this fall, Home Health Care News asked several CEOs and C-suite executives about their biggest concerns — and their plans for addressing them. In addition to the COVID-19 virus, respondents also touched on staffing challenges, consolidation and more.

Here are the top concerns of seven home health leaders as the industry heads into 2020’s final months.

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The biggest concern that we have is what will happen with COVID-19. We have seen a surge happen as young adults return to college and then spread this into the community. Will that negatively impact our senior populations or reduce the referrals we are seeing from some doctors who have resumed elective surgeries? We are working with doctors’ offices that we regularly get referrals from to discover their plans and plan how we can work together to mitigate the impact for both the agency and for the doctor.

Other referral sources like assisted living facilities have stayed on stringent lockdowns, and we see that continuing throughout the duration of the crisis. The concern here is for access to caregivers and the ability of staff to be able to go in and do their job appropriately to make sure that these seniors are not left behind as a result of the ongoing surge that we expect to continue for several months.

We are mitigating this by working with facilities to reduce exposure potential by assigning specific staff just to that facility, running daily ongoing COVID checks and possibly utilizing some of the testing capacity that we expect to see from the federal government for rapid tests. We also have a standing relationship with local testing facilities to get staff in and tested immediately if needed, so that we can do immediate checks and short-term quarantines. We then utilize backup staff who have office positions as a stopgap until the all clear notice is given.

— Beau Sorensen, chief operating officer at First Choice Home Health & Hospice

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The remainder of the year will be focused on a series of concerns including the need to increase provider support through the Provider Relief Fund, addressing Medicaid support shortfalls, securing support for telehealth reimbursement, and bolstering anticipated needs for PPE and staff testing.

Each of these items can be addressed through the ongoing stimulus legislation efforts or through Congressional action post-election. We have taken steps to cover both opportunities with targeted legislation on telehealth and Medicaid, along with broad supports in health care overall for the Provider Relief Fund, Medicaid, PPE and testing as part of the stimulus packages.

Given the extent of needs in the home care and hospice community, no one single focus is sufficient.

— William A. Dombi, president of the National Association for Home Care & Hospice (NAHC)

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My biggest concern going into the fall is a COVID-19 resurgence coupled with what could be a tough flu season. This puts our staff at greater risk and could have a terrible impact on the elderly and at risk populations.

How do we address this? By working to get 100% of our clinicians vaccinated against influenza, ensuring we have adequate PPE and keeping our staff up-to-date on how to avoid community-based infection while both on or off the job. The health of our staff is our highest priority, and we have to double down on what kept them safe in the early days of COVID.

The pandemic is far from over, and I fear that the fall could be far worse than the spring if we don’t continue to take real action to keep health care workers safe.

— Brent Korte, chief home care officer at EvergreenHealth Home Care

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As we move into fall, amidst this next phase of the pandemic or otherwise, our biggest concern remains caring for all patients with a range of health care needs: from high-acuity medical care to personalized non-medical support.

This means caring for the widest range of those who need our help, including pediatric patients with complex medical needs at home or in school while parents sort out virtual/hybrid learning models. It means setting up seniors with home aides to assist with meals and other chores. We’re also providing clinically based COVID-19 testing and screening services to ensure healthy work, learning and retail environments.

Our aim is that patients with milder COVID symptoms can transition home with the same high-quality care, while freeing up hospitals to support more intensive cases of COVID-19. To do this, we continue to fight the other battle, the caregiver shortage. To care for our patients, we search for and welcome the caregivers who want to give back, support their communities and make a difference in a job that is recession-proof and can change lives. Currently, those candidates could be from the many left jobless by the pandemic, including those from the hospitality, travel and restaurant industries.

Our challenge to meet patients where they are means being there to combat feelings of social isolation, especially as we approach the fall and winter seasons. By caring for our patients’ minds, bodies and spirit through our “Home Life Enrichment” standard-of-care, we can keep them healthy and safe but also connected to their loved ones and the world around them via in-person or telehealth interactions. For those facing end-of-life, meeting patients and their families with the support and comfort care of hospice in their final days and moments is what makes our team different.

— Jennifer Sheets, president and CEO of Interim HealthCare

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What are the top concerns for our home health agency this fall? Is it our star rating? Our patient satisfaction? Maintaining a low re-hospitalization rate? Is it delivering on value or ensuring compliance? Surveys? Staffing? The Patient-Driven Groupings Model (PDGM)? The Review Choice Demonstration (RCD)? Audits, payers, costs, technology or hospital narrow networks? COVID-19?

These are all yesterday’s concerns. Today’s top concern is how hospital systems and the U.S. Centers for Medicare & Medicaid Services (CMS) want the small home health agencies to close. This is good for the large providers that have exclusivity and control a majority of the Medicare revenue, but bad for small providers, which are the great majority of agencies in America. We don’t have a seat at the table regardless of cost, quality or patient’s choice.

The second concern is the volume increase of “low pay,” “slow pay” and “no pay” high case-mix patients who are having issues accessing care. Agencies are going to have to be providing their referral sources with 5-star care. If an agency has a bad referral source, it’s safe to assume they are another agency’s good one. If agencies keep taking bad referral sources hoping that they will turn into good ones, it will most likely accelerate an agency’s closure. Agencies must be continuously looking for partnership opportunities with referral sources that want value — or get an exit strategy.

— Peter Miska, president of Phoenix Home Care LLC

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The biggest concern — and opportunity — we have as an organization is the continued uncertainty, unrest and anxiety facing our communities, our patients, their families and our front-line “heroes” in the field. Adding fuel to “COVID-fatigue” is the unknown impact of the flu season aligning with a possible resurgence of the coronavirus. That requires us to remain vigilant in our support and messaging. We’ll continue to build upon what we have learned so far.

Over the last seven months, we have successfully navigated through the varying challenges of the pandemic to keep our patients, employees and communities safe. The result of this focus led to the implementation of new tools, technology and strong processes that have elevated home health in the continuum of care. We are reaching more patients, more families and serving our communities in different ways than we have in the past, putting us in a strong position to weather additional challenges as they come.

In response to the pandemic, we implemented innovative technology strategies and solutions to assist in keeping everyone as safe and connected as possible. As the flu and COVID-19 collide, we will continue leveraging our technology-based solutions such as remote patient monitoring, virtual visits and medication management delivery to enhance our care plans while supporting infection control measures and social distancing to minimize risk for our caregivers.

Regular COVID-19 training and flu education ensures a consistent approach to proven methodologies that have been implemented to protect our greatest resource – our staff – so they can do their best work for our patients.

We have used and will continue to use analytics to help make data-driven decisions during the pandemic. We have refined processes and implemented changes based on our learnings to ensure the safety of all. We have focused equal effort into providing tools and resources to our front-line caregivers to ensure they are safe, engaged, supported and have what it takes to be resilient in hard times.

— Dan Dietz, president and CEO of CommonSpirit Health at Home

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Trinity Health At Home has seen an increase in home care visits at faster rates than expected this quarter. As patients across our nation continue to seek equal access to health care, the need for home care services continues to climb. As home care providers, we must continue monitoring and improving our processes to ensure current and future patients have access to care. At the start of the pandemic, we adapted quickly across our home health agencies to meet patient needs under new circumstances. Our innovation will continue in the brighter days ahead.

Though we have all adapted to COVID-19, we must continue to take our COVID-19 response and processes very seriously. At Trinity Health At Home, the safety and well-being of our patients and colleagues remain our priority moving forward. Right now, support for our devoted nurses and clinicians is of utmost importance. We are securing additional supplies of PPE, ensuring the safety of staff on home visits and encouraging self-care to limit the stress and uncertainty of our new normal. By keeping our colleagues healthy and engaged, we can ensure proper staffing levels to guarantee high-quality home care and expand access to care within our communities.

— Mark McPherson, president and CEO of Trinity Health At Home

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Senior Care Stakeholders: Latest COVID-19 Relief Proposal Is ‘Shameful,’ ‘Anemic’

Senate Republicans are close to unveiling their latest version of another coronavirus relief bill, with reports suggesting party leaders may do so Wednesday or soon thereafter.

The proposal — first obtained by Washington, D.C.-based newsroom Roll Call — is viewed as a “skinny” version of the previously released HEALS Act from July. Among its provisions, the Republican plan seeks to provide $300 in weekly unemployment insurance, additional money for coronavirus testing and another $158 billion for the Paycheck Protection Program (PPP), which closed for applications on Aug. 8.

Of note for home health providers and other organizations operating in the long-term and post-acute care spaces, the skinny bill appears to do little to alleviate financial and workforce hardships triggered by the public health emergency. In turn, it offers “no real relief” to the older Americans such providers serve, according to Katie Smith Sloan, president and CEO of the national aging services advocacy group LeadingAge.

“When eight out of 10 COVID deaths are among people 65 and older, and infections in nursing homes are breaking new records, it’s shameful to largely ignore the continued deaths and escalating danger to older adults,” Sloan said in a statement Wednesday.

To some extent, a drop in federal unemployment from $600 to $300 per week could lessen the number of in-home care workers opting out of their jobs during the ongoing crisis due to safety concerns. Those anxieties have contributed to some home health and home care agencies losing several workers over the past few months, despite the fact unemployment rates remain high.

Additionally, a reopening of PPP — with the program stocked with fresh funding on top of leftover funds — would likely go a long way in supporting small and mid-sized home-based care businesses.

Overall, more than 15,000 home-based care entities received PPP loans of less than $150,000 under PPP, according to a review of federal data conducted by Home Health Care News. More than 7,400 entities have received loans at or above $150,000, with dozens receiving loans in the $5 million-to-$10 million range.

“For those Interim HealthCare owners who applied and received funding, the PPP loan allowed them to ensure their teams of home health aides, nurses and other staff members could continue to serve their patients, safely in the comfort of their own homes by front-line staff who had access to the right resources, including proper personal protective equipment (PPE),” Jennifer Sheets, president and CEO of Interim HealthCare Inc., told HHCN in an email.

The Republic plan would also allow for a “second draw” on PPP for eligible businesses that have suffered a 35% revenue loss over a designated period, Roll Call reported.

Beyond those provisions, the plan would allocate a total of $16 billion to support COVID-19 testing and contract tracing. But aging services providers alone need at least $10 billion in testing aid, according to LeadingAge.

That’s especially true for long-term care hospitals (LTCHs), in-patient rehabilitation facilities (IRFs) and others, as testing is directly tied to Medicare payments. New guidance from the U.S. Centers for Medicare & Medicaid Services (CMS) says that such providers who want to get paid for treating COVID-19 patients must include a positive test in that patient’s medical record.

“This isn’t just skinny,” Sloan said. “It’s anemic.”

Moving forward, LeadingAge argues, the “continuum of aging services providers” — home health and home care agencies included — need more PPE, testing supplies and funding to cover “hero pay” for front-line workers, among other measures.

Gary Anderson, CEO of Lutheran Senior Services, echoed that call to action. St. Louis, Missouri-based Lutheran Senior Services is a provider of retirement communities, home- and community-based services and affordable housing.

“COVID has made this the most difficult year in our 160-year history,” Anderson said in a statement. “In the early days of the crisis, we lacked the necessary PPE and vendors did not have the inventory to supply us. It’s still hard to locate PPE — and we are spending tenfold on what we can afford.”

Across the organization, Lutheran Senior Services is on track to spend over $1.5 million on testing alone.

Assisted living communities have been hit particularly hard by the COVID-19 emergency and a lack of federal action.

In a survey of 193 U.S. assisted living providers conducted this month by the National Center for Assisted Living (NCAL), half said they were currently operating at a loss. Another 64% of assisted living providers said they won’t be able to sustain operations another year at the current pace of increased costs and revenue loss.

LeadingAge is not the only aging services advocacy organization to call for more federal support.

The Partnership for Medicaid Home-Based Care (PMHC), for example, is urging Congress to create a fund to help pay direct care workers higher wages during the public health emergency. The National Association for Home Care & Hospice (NAHC) has likewise called for more telehealth assistance, while the Partnership for Quality Home Healthcare (PQHH) is seeking an immediate pause to the Review Choice Demonstration (RCD).

The new “skinny” proposal is expected to cost about half as much as the previous $1 trillion COVID-19 relief legislation, according to The Wall Street Journal. Still, that price tag may be too high for some Republicans.

Meanwhile, House Democrats initially floated a $3.5 trillion plan of their own, though they signaled they’d be open to shaving that by about $1 trillion.

Roll Call noted the proposal text it obtained is subject to change.

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Dozens of Home-Based Care Businesses Have Received PPP Loans of $5M+

Since funds became available, in-home care businesses across the U.S. have received more than $666.36 million in loans of under $150,000 via the Paycheck Protection Program (PPP), a July Home Health Care News review of federal data found.

They have received hundreds of millions of dollars in large PPP loans at or above $150,000 as well, a new follow-up analysis reveals.

Created by the CARES Act, PPP is a potentially forgivable loan program designed to keep small and mid-sized businesses afloat during the economic fallout triggered by the COVID-19 virus. As of Aug. 3, more than 5 million PPP loans have been approved, adding up to more than $521 billion, according to the Small Business Administration (SBA).

Home health and home care providers have, in some instances, turned to PPP to overcome sudden dips in business due to patients and clients refusing service.

Some providers have additionally used PPP funds to better retain workers by financing bonuses, hazard pay and other compensation initiatives.

“With the help of PPP and other smart financial readiness and resources, Interim HealthCare operators have been able to continue paying [their] essential employees on the front lines,” Jennifer Sheets, president and CEO of Interim HealthCare Inc., told HHCN in an email. “It has allowed owners to expand their reach so home care continues to be a vital resource and strategic weapon to battle this public health emergency and to support more people in their local communities across the 41 states we collectively serve.”

Sunrise, Florida-based Interim HealthCare is a diverse home-based care franchise company with hundreds of locations across the U.S.

Combined, businesses delivering some form of in-home care have received more than 7,400 individual PPP loans at or above $150,000, HHCN’s follow-up analysis found. Those loans range from a minimum of $150,000 to a maximum of $10 million.

The amount any small business is eligible to borrow is 250% of its average monthly payroll expenses, up to a total of $10 million.

Congress mainly designed PPP as a way for companies to keep workers on payroll, but it has also been a valuable tool for paying for costly medical supplies during the COVID-19 crisis.

“We continue to see the need for full loan forgiveness for franchise owners, as other expenses during COVID-19, such as PPE, have been very challenging,” Sheets said.

While the bulk of PPP recipients are part of standalone corporations or independent businesses, many individual franchise locations also received support.

More than a dozen Interim HealthCare locations received PPP support to help with the operational challenges of COVID-19, for example.

“As COVID-19 cases began to rise across the country and hospitals experienced a surge in patients, the need for home health care became more important than ever,” Sheets said. “For those Interim HealthCare owners who applied and received funding, the PPP loan allowed them to ensure their teams of home health aides, nurses and other staff members could continue to serve their patients, safely in the comfort of their own homes by front-line staff who had access to the right resources, including proper personal protective equipment (PPE).”

Franchise locations from Right at Home, Senior Helpers, ComForCare and several other major home care franchisers also received PPP support, federal data shows.

The different ranges

To analyze PPP data, HHCN used NAICS code 621610, which includes “establishments primarily engaged in providing skilled nursing services in the home” and a range of other in-home care entities.

In addition to home health and home care agencies, the code includes hospice providers, companies that deliver in-home therapy services and others.

In the PPP loan category of “at or above $150,000,” most in-home care businesses applied for loans in the range of $150,000 to $350,000. In fact, of the more than 7,400 large PPP loans issued to in-home care businesses, more than half were within that range.

About one-third of in-home care businesses that applied for large PPP loans were in the $350,000-to-$1 million range, HHCN’s analysis shows. Slightly more than 12% applied for loans that checked in somewhere between $1 million and $5 million.

A total of 63 in-home care businesses linked to NAICS code 621610 were issued PPP loans in the $5 million-to-$10 million range.

Examples include Nizhoni Health, a Massachusetts-based home health provider that specializes in patients with acute mental illnesses, along with California-based Mission Healthcare, which recently launched an innovative palliative care program meant to keep vulnerable populations “out of no man’s land.”

The data analyzed by HHCN did not provide specific amounts secured by each PPP recipient.

Geographic breakdown

Current law dictated that the Paycheck Protection Program close at the end of Aug. 8. As such, SBA is no longer accepting PPP applications from participating lenders.

When PPP did close, it did so with more than $130 billion in unused funds left on the table. Depending on what Congress does in terms of passing another federal stimulus package, it’s entirely possible that more PPP support is on the way, however.

Overall, about 51 million jobs were saved due to PPP, according to government statistics. S&P Global estimates that number is actually closer to 13.6 million.

When it comes to where PPP funding is going, in-home care companies in Texas received the highest number of large loans, followed by in-home care entities in California and Pennsylvania.

General corporations, limited liability companies and Subchapter S corporations received more than 90% of all large PPP loans that went to in-home care companies. Nonprofit organizations received about 5% of large PPP loans, with sole proprietorships receiving less than 2%.

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With Stimulus Deadline Nearing, Home-Based Care Industry Scrambles to Secure Additional Relief

Friday is the deadline set by House Democrats and Senate Republicans for agreeing to a new coronavirus stimulus package. Home-based care stakeholders have had ample time to review the publicly released details from both parties’ plans — and they have a wishlist of additional provisions they’re still hoping to see.

One of the central pain points sparking disagreement between Democrats and Republicans in the next stimulus package is unemployment benefits.

Previously, individuals who lost their jobs during the public health emergency could receive $600 per week from the federal government, in addition to any state-level benefits.

In many cases, those benefits outpace what home-based care agencies are able to pay their workers.

“The unemployment accelerated benefits definitely have been a challenge,” Jennifer Sheets, the CEO of Interim HealthCare Inc., told HHCN in June. “Early on, we had struggled even with some front-line workers asking to be laid off or let go, which makes you scratch your head and say, ‘How does this make sense?’”

Sunrise, Florida-based Interim HealthCare offers a wide variety of in-home care services, with nearly 300 locations across the U.S.

Part of the Republicans’ proposed HEALS Act has been re-employment bonuses for those who willingly go back to work. Republicans also pitched tax credits for businesses that employ those people.

Additionally, the Republicans’ proposed HEALS Act would cap federal unemployment benefits to $200 weekly until at least October, or cap payouts to 70% of an individual’s previous income.

July 31 marked the end of the CARES Act’s $600 weekly benefit.

In a recent SEIU tele-town hall, more than 80% of the 21,000 home care workers that convened said they felt the federal government had not “done enough to ensure home care workers have what [they] need” during the COVID-19 crisis.

Apart from unemployment-related provisions, home-based care advocates are hoping for more money in the Provider Relief Fund, which previously distributed over $175 billion to health care providers from the CARES Act.

The Democrat-led House of Representatives proposed $100 billion more for the fund. Meanwhile, Republicans suggested a $25 billion infusion in their HEALS Act proposal.

Some believe the latter figure is not even close to where it needs to be. That includes LeadingAge President and CEO Katie Smith Sloan.

“The legislation treats older lives as expendable,” Sloan said in a statement. “The resources provided are woefully insufficient. The package offers only a fraction of the $100 billion that will be needed to help aging services providers protect older adults and offers no specific funds for aging services providers.”

Additionally, multiple organizations have expressed that there needs to be more support for Medicaid home- and community-based services.

The Partnership for Medicaid Home-Based Care (PMHC) specifically did so in a statement on Thursday.

“The financial viability of Medicaid home- and community-based providers is critical to the national health care infrastructure, and the direct care workforce needs financial support to ensure the continuation of these essential services,” PMHC Chairman David Totaro said.

PMHC previously developed a proposal for Congress that included an HCBS Direct Care Workers Fund.

On his end, National Association for Home Care & Hospice (NAHC) President William A. Dombi hopes there may be an extension of the payback timetable and the level of interest under the Centers for Medicare & Medicaid Services (CMS) advanced and accelerated Payment programs.

CMS distributed more than $100 billion in advanced and accelerated payments to all Medicare providers in spring. Home health providers received $1.7 billion.

NAHC is also hoping that the telehealth waivers granted during the public health emergency will become permanent, such as the one that allows the face-to-face requirement to be settled with telehealth technology.

However, for the big domino to fall in telehealth — reimbursement for remote visits — home health providers will need to wait for Congressional action.

“Absence of reimbursement for telehealth [in the bill is a concern],” Dombi told HHCN. “We have significant Congressional support, but the measure may not make it into this stimulus package, and we may need to wait for the next opportunity.”

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Time for Policymakers, Hospitals to Bet Big on Home-Based Care

It’s time for policymakers, hospitals and everyone else at the health care roulette table to bet all their chips on proactive, pre-acute home-based care.

During the coronavirus pandemic, the U.S. health care system has undergone a massive change marked by the skyrocketing use of telehealth technology and the shift away from brick-and-mortar medical appointments. In fact, from April 2019 to April 2020, telehealth claim lines have increased by more than 8,300% nationally, according to FAIR Health data.

For the most part, though, traditional home-based care has felt like a secondary priority over the past few months, with home health providers and home care agencies largely overshadowed by telehealth trends, hospital capacity concerns and the general state of nursing homes, which continue to be devastated by COVID-19.

“I think that [policymakers] have been very responsive to the needs in the hospital setting,” a Maine home health executive previously told Home Health Care News. “I do not feel that they fully understand the complexity of the patients seen by home health and hospice providers.”

Health care stakeholders may have missed the opportunity to aggressively invest in home health and home care during the initial coronavirus spike, but that door is opening wide once again. Or rather, it never really closed.

The country’s rolling seven-day average of daily new COVID-19 cases shattered all previous records on Monday for the 28th day in a row, the Washington Post reported. At the same time, hospitals across the Sun Belt are being overwhelmed by coronavirus patients, with Arizona reaching 89% capacity for intensive care unit beds and California, Georgia, North Carolina, Texas and a handful of additional states experiencing unprecedented hospitalization numbers.

The new coronavirus spikes in the South and West aren’t part of a different, second COVID-19 wave. They’re continuations of the first wave that was never properly addressed.

Overall, the U.S. death toll linked to the coronavirus hit 130,000 this week, statistics from Johns Hopkins University show. The number of total infections is approaching 3 million.

With those numbers in mind, Dr. Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases and a leading member of the Trump administration’s coronavirus task force, is calling for urgent action.

“It’s a serious situation that we have to address immediately,” Fauci said during an online interview Monday with Dr. Francis Collins, who leads the National Institutes of Health as its director.

As part of the nation’s renewed response to the coronavirus, home health and home care need to now be front and center. Fortunately, there are several readily available actions out there that the federal government and other health care players can take to support all shapes and sizes of in-home care providers.

When it comes to home health care agencies, in particular, the U.S. Centers for Medicare & Medicaid Services (CMS) can start by reopening its advanced and accelerated payment programs, allowing operators to focus on patient care and not their finances.

Home health agencies experienced huge financial losses during the early days of the coronavirus due to patients canceling visits and the general suspension of elective surgeries. Cash flow disruptions have somewhat stabilized, but the recent resurgence of COVID-19 cases may retrigger the same anxieties and roadblocks that agencies had to previously overcome.

From March through April, CMS distributed more than $100 billion in advanced and accelerated payments to all Medicare providers. Home health providers received just $1.7 billion of that before CMS shut down the programs — and many home health agencies in emerging hotspots never even had the opportunity to apply for payments, as they’re just now feeling the impact of the coronavirus.

On top of reopening its advanced and accelerated payment programs, CMS should also consider giving home health providers a more robust Medicare rate adjustment. While the National Association for Home Care & Hospice (NAHC) and other industry advocates have called for a 15% rate increase, CMS recently suggested a 2.6% reimbursement bump in its proposed payment rule for 2021.

Many home health providers won’t be able to stay afloat for much longer without additional financial lifelines. In New York alone, home-based care providers expect to lose upwards of $200 million in 2020, according to financial estimates by the Home Care Association of New York State (HCA-NYS).

“These losses have alarming implications for the viability of New York’s home care system and the necessary support it provides for patients,” Roger Noyes, director of communications at HCA-NYS, previously told HHCN.

Meanwhile, when it comes to supporting home care agencies, Congress should start by seriously considering the creation of a fund that helps operators finance hazard pay and other benefits for front-line workers in its next relief package.

It’s an idea that had been floated by House Democrats in their Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act unveiled in May. Specifically, the House bill included a $200 billion fund for hazard pay for all essential workers.

Interim HealthCare Inc. CEO Jennifer Sheets previously told HHCN she would “love to see” government-supplemented hazard pay for health care workers.

“We need to incentivize people to be on the front line, especially in a pool that’s already prone to high turnover,” she said.

Apart from financial assistance, the Trump administration and FEMA should also organize a personal protective equipment (PPE) push for in-home care providers, similar to what they did for nursing home operators back in April. In-home care agencies have had just as difficult a time securing PPE, if not greater, as they’ve been excluded from most priority lists during the COVID-19 crisis.

Outside of the government, hospitals also need to accelerate the shift toward in-home care. Many already have, including North Memorial Health Hospital in Minnesota, which recently partnered with whole-person, home-based care provider Lifesprk to offer a hospital-at-home model.

“With the outbreak and shortage of personal protective equipment (PPE), one of the just really sad things that all of us have witnessed is when someone goes into the hospital right now and is very sick, their loved ones can’t be there with them,” Dr. Carolyn Ogland, North Memorial’s CMO, previously told HHCN. “This is a way to really help our families and our patients stay together when they are sick.”

If the U.S. health care system acts quickly and invests in home-based care, it will emerge from COVID-19 stronger than ever. But the window of opportunity is closing, so stakeholders must act now.

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