The long-term care sector is looking at positive demographics for business in 2010. An aging population – and more people who are choosing home care and want to avoid institutions – should keep the home care, hospice and durable medical equipment communities busy.
“We’re not pleased with across-the-board cuts for home health and hospice,” said Peter Notarstefano, the American Association of Homes and Services for the Aging’s director of home and community-based services. “Demonstrations for pay-for-performance program have only been launched in seven states. But we could see more managed care, and a breaking down of silos in Medicare and Medicaid (in 2010.)”
According to Notarstefano, the rules in Medicare and Medicaid are so different, it’s like treating two different people. P4P stresses outcomes, not volume, he said.
There are a number of provisions in the proposed health reform bills that improve eligibility for home- and community-based services in Medicare and Medicaid.
“Slowly but surely, we’re seeing more options, said Notarstefano. “The CLASS Act plan is in both bills, which provides $75-a-day allowance for elder care.”
Another provision gets physicians to coordinate with home health agencies to do house calls; it’s another type of P4P.
“Overall the outlook is very optimistic for DME providers, there are strong opportunities on the horizon, said Walt Gorski, vice president of government affairs for the American Association of Homecare. “Many of them have the means to take advantage of technology.”
Making sure that durable medical equipment distribution is fair, and that the smaller DME providers aren’t pushed out of the system, will be a big topic in 2010.
“That’s one of the scary parts about having a bidding system on anything,” said Notarstefano. “It’s not based upon quality.”
This year, it’s expected that more people will be brought into the healthcare tent, but this is not the case with DME providers, according to Tyler Wilson, president and CEO of the AAH.
“Those DME providers who are eligible aren’t all signing up,” he said.
Competitive bidding affects a large swath of the industry, occurring now in eight to 10 different product categories.
“Congress and (the) Centers for Medicare and Medicaid seem to look at DME only as a commodity, services aren’t considered. This results in cutting back,” said Gorski. “It’s penny-wise and pound-foolish.”
“It’s not appropriate in this industry with patient care attached to the (equipment use and purchase). It’s more than a trend; it’s occurring,” said Wilson.