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.
CMS Issues Report on Acute Hospital Care at Home
What’s happening: As required by the Consolidated Appropriations Act (CAA) of 2023, the Centers for Medicare & Medicaid Services (CMS) has issued a report on several aspects of the Acute Hospital Care at Home (AHCaH) initiative, which provided waivers that allowed individual hospitals to give inpatient-level care in the home environment.
What else to know: The waiver program launched during the COVID-19 public health emergency (PHE), and the CAA extended it beyond the PHE’s end, allowing it to continue through Dec. 31 of this year.
Summary: Finalized Mental Health Parity Regulations
What’s happening: CHA has issued a members-only summary of the Mental Health Parity Final Rule that aims to improve access to mental health services by requiring health plans to make changes when inadequate access is provided.
What else to know: The regulations are effective Nov. 22.
DHCS Takes Steps to Expedite Access to Enhanced Care Management
What’s happening: Effective Jan. 1, 2025, Medi-Cal managed care plans (MCPs) must implement presumptive authorization arrangement with select providers of enhanced care management (ECM).
What else to know: The Department of Health Care Services (DHCS) is releasing updates to the ECM presumptive authorization policy parallel to the ECM Referral Standards that, together, are designed to ease the administrative burden of the referral and authorization process on ECM providers and community referral partners.
CMS Updates Training on Post-Acute Care and More
What’s happening: The Centers for Medicare & Medicaid Services (CMS) is offering a web-based training course on the post-acute care (PAC) patient assessment instruments (PAI) and quality reporting programs (QRPs) for all PAC settings.
What else to know: The updated training provides a high-level overview of data elements within the patient/resident assessment instruments across PAC settings, including inpatient rehabilitation facilities (IRFs), skilled-nursing facilities (SNFs), long-term care hospitals (LTCHs), and home health (HH) agencies, and discusses the relationship between these data elements and the QRP for each setting.
Mental Health Parity Rules Finalized
What’s happening: The departments of the Treasury, Labor, and Health and Human Services have finalized rules to improve access to mental health services by requiring health plans to make changes when inadequate access is provided.
What else to know: The final rule reinforces the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), which requires health plans to ensure that access to mental health or substance use disorder care is not more restrictive than access to medical and surgical benefits.