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 Offers Updated Training on PAC QRP
What’s happening: The Centers for Medicare & Medicaid Services (CMS) is offering a series of updated web-based training courses on coding cross-setting data elements for Section GG of the post-acute care (PAC) patient assessment tools.
What else to know: Section GG collects admission and discharge information about functional status for patients in long-term care hospitals (LTCHs), inpatient rehabilitation facilities (IRFs), skilled-nursing facilities (SNFs), and home health agencies (HHAs).
CHA Comments on CY 2025 Home Health Payment Rule
What’s happening: CHA submitted comments to the Centers for Medicare & Medicaid Services (CMS) in response to the calendar year 2025 home health prospective payment system proposed rule.
What else to know: CHA thanks members for their feedback, which helped to inform comments.
New Provider Complaint Process Aims to Increase Federal Oversight of Medicare Advantage Plans
What’s happening: The Centers for Medicare & Medicaid Services (CMS) has implemented a new process allowing providers to submit questions and complaints related to Medicare Advantage (MA) plan appeals or claims payment issues.
What else to know: CHA welcomes these first steps in establishing greater CMS oversight for MA plans. The MA final rule, which took effect on Jan. 1, codified important new policies and expectations for MA plans, directed toward greater alignment between traditional Medicare and MA.
DHCS Releases CalAIM Transitional Care Resource
What’s happening: The Department of Health Care Services (DHCS) has issued a new resource to support the development and implementation of transitional care services, a component of California Advancing and Innovating Medi-Cal (CalAIM), the state’s Medi-Cal reform initiative.
What else to know: Under CalAIM, Medi-Cal managed care plans are responsible for delivering transitional care services to members who are transferred from one setting or location to another, such as discharged from a hospital to a skilled-nursing facility or to home. As envisioned, these services support individuals from the start of the discharge planning process through their transition until they have been successfully connected to needed long-term services and support.
CHA Issues Summary of FFY 2025 LTCH PPS Final Rule
What’s happening: CHA has issued a summary of the finalized payment updates and policies for long-term care hospitals (LTCHs) for federal fiscal year (FFY) 2025.
What else to know: The policy and payment provisions are generally effective for FFY 2025 discharges, beginning Oct. 1.
New CMS Requirements for Reporting of Hospital Respiratory Data to NHSN
What’s happening: Beginning on Nov. 1, the Centers for Medicare & Medicaid Services (CMS) will require acute care hospitals and critical access hospitals to electronically report information via the National Healthcare Safety Network (NHSN) about COVID-19, influenza, and respiratory syncytial virus (RSV).
What else to know: CMS will also require hospitals to provide a weekly snapshot of hospitalizations, admissions, bed capacity and occupancy, and weekly totals for new admissions for COVID-19, influenza, and RSV to provide situational awareness of the impact of these respiratory diseases.
Summaries Available: FFY 2025 Post-Acute Care Payment Final Rules
What’s happening: The Centers for Medicare & Medicaid Services (CMS) issued its final payment rules for inpatient rehabilitation facilities (IRFs), skilled-nursing facilities (SNFs), and hospices for federal fiscal year (FFY) 2025. CHA has issued members-only summaries of each rule.
What else to know: In general, the payment updates were slightly higher than proposed, but still inadequate relative to input price inflation.
CHA to Host TEAM Bundled Payment Final Rule Webinar on Aug. 14
What’s happening: CHA will host the Transforming Episode Accountability Model (TEAM) Bundled Payment Final Rule Webinar on Aug. 14 at noon (PT).
What else to know: The event is free for CHA members. Registration is open.
CHA DataSuite Releases CY 2025 Home Health Proposed Rule Impact Analysis
What’s happening: CHA DataSuite has issued a hospital-specific analysis of the Medicare hospital calendar year (CY) 2025 Medicare home health (HH) prospective payment system (PPS) proposed rule analysis.
What else to know: The analysis is intended to show HH providers how Medicare fee-for-service payments will change from CY 2024 to CY 2025 based on the policies set forth in the proposed rule.
CMS Releases Post-Acute Care, Psych Payment Final Rules
What’s happening: The Centers for Medicare & Medicaid Services (CMS) issued the federal fiscal year (FFY) 2025 inpatient rehabilitation facility (IRF) prospective payment system (PPS), skilled-nursing facility (SNF) PPS, inpatient psychiatric facility (IPF) PPS, and hospice wage index final rules.
What else to know: The policy and payment provisions in the final rules will be effective for FFY 2025 discharges, beginning Oct. 1.