About Continuum of Care
Post-acute care — often provided at inpatient rehabilitation facilities, long-term care hospitals, skilled-nursing facilities, and at patients’ homes — is vital to the health care delivery system. These providers deliver essential medical and rehabilitative services following hospital care. Hospital case managers help support, and connect patients, families, and caregivers through communication and coordination with post-acute care providers and home and community-based services. This includes the development of a discharge or transition plan that addresses the patient’s goals, needs and treatment preferences, and prepares patients and caregivers for post-discharge care.
New Managed Care Plan Changes in January Help Advance Health Equity, Access, and Accountability
What’s happening: Effective Jan. 1, 2024, Medi-Cal managed care plans (MCPs) will operate under a new and revamped contract intended to better advance quality, access, accountability, health equity, and transparency.
What else to know: Also effective Jan. 1, 2024, MCPs available for enrollment in certain counties will change due to county-elected model changes, the awarding of new commercial MCP contracts, and/or the expansion of direct contracts with Kaiser Permanente.
CDPH Updates COVID-19 Guidance to Prepare for Winter Virus Surge
What’s happening: The California Department of Public Health (CDPH) has published All Facilities Letter 23-26, which streamlines and updates recommendations for the prevention and control of COVID-19 and other respiratory illnesses in skilled-nursing facilities (SNF).
What else to know: SNFs are asked to ensure staff readiness for the upcoming winter respiratory virus season, which includes prompt testing and treatment.
Children’s Behavioral Health Services Lack Timely Access
What’s happening: The California State Auditor recently investigated children’s access to Medi-Cal-covered behavioral health services.
What else to know: The auditor concluded that many Medi-Cal health plans were out of compliance with state requirements for timely care and that the Department of Health Care Services (DHCS) is not adequately disciplining health plans.
Summary: Proposed Policy Changes for Medicare Advantage Plans
What’s Happening: A members-only summary from Health Policy Alternatives, Inc. of the proposed policy changes for Medicare Advantage (MA) plans is available.
What Else to Know: The proposed policies affect MA (Part C), Medicare Prescription Drug Benefit (Part D), Medicare cost plans, and Programs of All-Inclusive Care for the Elderly.
Updated Guide on Final Rule Implementation Now Available
What’s happening: A members-only guide from the American Hospital Association to support hospitals in the implementation of the Medicare Advantage (MA) final rule is now available for calendar year 2024.
What else to know: The document provides a summary of key provisions of the final rule, which seeks to align MA coverage with traditional Medicare more clearly and to increase oversight of MA plans.
Summary: Finalized Policies Address Physician Payment and Quality Updates
What’s happening: A members-only summary from Health Policy Alternatives, Inc. discusses the final physician payment policies for calendar year (CY) 2024.
What else to know: Policies are effective Jan. 1.
Final Home Health Rule Reduces Impact of Behavioral Adjustments on Providers
What’s happening: The Centers for Medicare & Medicaid Services (CMS) has issued the final rule for the home health prospective payment system for calendar year 2024.
What else to know: Medicare payments to home health agencies will increase in the aggregate by 0.8% instead of the 2.2% decrease that was originally proposed.