End of Public Health Emergency: Its effect on Home Health Care
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When the public health emergency (PHE) was declared, a few regulatory waivers and flexibilities were given to streamline medical procedures and lessen the pandemic's overall toll on healthcare providers.
Three years after it was declared, President Biden announced that the COVID-19 PHE would end on May 11, 2023. This may have some implications for home health providers, who were given a number of waivers and flexibilities.
Initial and comprehensive assessments
Mollie Gurian, vice president of home health and HCBS policy at LeadingAge expressed that several mission-driven home health members are concerned with the end of the waiver that allows therapists to perform the initial and comprehensive assessments for all patients.
She added that due to the nursing shortage, home health agencies have valued the crucial flexibility of using therapists to conduct initial assessments on home health patients in order to begin care, even when they are nursing based. They urge CMS to think about how to increase this flexibility in areas where there is a severe shortage of nurses.
Training and supervision activities
Bill Dombi suggests that the PHE was a valuable learning opportunity for both CMS and providers in terms of administrative requirements. He believes that there are some administrative flexibilities, such as those related to training and supervision activities, that CMS should consider maintaining on a permanent basis.
He also highlights the importance of gaining a better understanding of what is truly necessary in terms of administrative structure, and what is not. During the PHE, providers gained an increased appreciation for certain structures that ensure the quality of care, but Dombi suggests that CMS has also learned about overdoing it with regards to administrative structure.
In Dombi's view, it may be more efficient to achieve desired outcomes in alternative ways, rather than continuously adding layers of administrative processes. By taking a more thoughtful approach to administrative requirements, both CMS and providers can focus on providing the highest quality of care to patients while minimizing the administrative burden.
The impact, however, may not be as daunting as initially anticipated because the majority of the biggest issues have already been addressed by Congress and the Centers for Medicare & Medicaid Services (CMS).
Face-to-face encounters addressed
As stated by Bill Dombi, President of the National Association for Home Care & Hospice (NAHC), the recent actions taken by Congress have ensured that the home health care industry will not suffer significant losses due to the COVID-19 pandemic.
Specifically, he noted that the Centers for Medicare and Medicaid Services (CMS) made a permanent change to its regulations early in the pandemic, which allows for virtual visits to be used in place of in-person encounters, provided they are authorized by the patient's treating physician or practitioner.
This represents a significant shift in the provision of home health services and highlights the efforts being made to adapt to the challenges posed by the pandemic. With the ability to utilize telehealth technology, patients can receive the necessary face-to-face encounters required for their home health care services without the need for in-person visits.
Acute Hospital Care at Home waiver extension
According to Krista Drobac, founder of Moving Health Home, another factor that could decrease the effects of the PHE's termination is the extension of the Acute Hospital Care at Home waiver, which was originally connected to the PHE.
Through the recent $1.66 trillion spending bill, the Acute Hospital Care at Home waiver, has been extended for an additional two years. This extension will allow healthcare providers to continue to deliver critical care services to patients in their homes, a crucial aspect of health care delivery especially during the ongoing pandemic.
In addition to the waiver extension, the bill also grants providers the freedom to substitute telehealth technology for a few in-person encounter requirements up until 2024. This is an important development that recognizes the crucial part telehealth can play in ensuring patients receive the care they require while lowering their risk of exposure to COVID-19.