Moving from home care to home-based services

Photo courtesy of Gretta Blankenship

Photo courtesy of Gretta Blankenship

It’s time to change what we call ourselves…move from thinking of the Colorado Visiting Nurse Association (VNA) as a “non-profit home health care agency” to a “non-profit organization that provides home-based services”. This may seem like a small distinction, but it there are three reasons we should make this change:
1) “Home health care” agencies are defined by outdated Medicare regulations specifically focused on controlling home care as a way to decrease fraud and abuse within a fee-for-service payment environment.
2) Second, there is very little government and/or insurance company reimbursement for para-based services focused on helping patients remain independent in the home.
3) Further, there is very little coordination of care across our various divisions because of the differing ways we are paid for care that we provide.

The Colorado Visiting Nurse Association has begun to think differently about the care we provide as healthcare transitions from a fee-for-service (FFS) payment system to one where healthcare organizations are paid for overall care and health outcomes.
Currently there are many differences between the care provided by each of our home-focused divisions; home health, paraprofessional home services and hospice/palliative. Care provided by our home health professionals is mostly regulated by Medicare and requires patients to be “home-bound” and have a documented needed for care provided by an RN, PT, LPN, etc.

By definition, paraprofessionals are workers who are not qualified or licensed to serve in particular professions but who handle tasks in support of qualified professionals in those fields. Paraprofessionals often work alongside fully qualified professionals, but they also sometimes work more independently, such as in the case of the health care paraprofessionals who provide home visits to the disabled, ill or elderly.

Care provide by paraprofessionals is more proactive in nature and is provided to help patients remain independent in the home, e.g., bathing, shopping, house-keeping, getting in and out of bed, etc. Hospice visits for appropriate patients are similar to home health visits in that hospice patients have to meet strict criteria for admission, i.e. patients must have a terminal diagnosis and patients must have a prognosis of having less than six months to live.

As one can see, there is a big barrier between the care provided by paraprofessionals and home health and hospice; the barrier has to do with the strict Medicare definitions put in place to help decrease overuse and abuse of skilled home health. Bottom line: the way home health services are reimbursed in our country is too focused on decreasing costs and abuse, rather than on improving care for patients.

The good news is that the old ways of paying for the care we provide are beginning to change as Medicare begins to move to paying for the value provided in the home, rather than just for an episode of care. Here is an excerpt taken from the recent U.S. Department of Health and Human Services Report to Congress: Plan to Implement a Medicare Home Health Agency Value-Based Purchasing Program. The report details a summary of Medicare’s view of the problem of fraud, as well as the limited connection between payments and quality of care.

“…the Medicare Payment Advisory Commission (MedPAC), the Office of the Inspector General, the General Accounting Office (GAO), and other stakeholders have raised significant concerns with fraud and abuse in the Medicare home health benefit. While the benefit is designed to encourage teams of skilled professionals to provide patient-focused care to homebound beneficiaries, there is growing concern that the existing payment system does not provide the necessary incentives to provide such high quality patient focused care.”

There is a lot that is changing in healthcare. Care provided in the home is fast becoming of vital importance to improving the health of populations of patients.

– Christopher Lee, Colorado VNA President & CEO, July 13, 2015

Prescription drug safety starts with all Coloradans

Facebook #1 TMS 2015
In February 2015, Governor John Hickenlooper launched the “Take Meds Seriously” public awareness campaign. “Take Meds Seriously” is a new statewide campaign advocating for the safe use, storage and disposal of prescription drugs in Colorado.

Behind this vital campaign is a group called The Colorado Consortium for Prescription Drug Abuse Prevention. The Consortium consists of a very impressive list of community partners, each of whom is participating in one of six work groups.

According to the campaign website, “The mission of the Consortium is to reduce the abuse and misuse of prescription drugs in the State of Colorado through improvements in education, public outreach, research, safe disposal, and treatment. The goal of these efforts is to prevent 92,000 Coloradans from misusing opioids by 2016.”

Grim statistics and recent surveys reveal how pervasive prescription drug misuse and abuse is in Colorado. Thirty-five Coloradans died a month in 2013 from unintentional drug overdoses.

Gov. Hickenlooper announced on February 24, 2015, “Colorado ranks 12th in the nation for abuse and misuse of prescription drugs. This campaign is just one part of a coordinated, statewide strategy that simultaneously restricts access to prescription drugs for illicit use, while ensuring access for those who legitimately need them. The messages and tools provided through this effort will help us take on this serious public health challenge, as part of our commitment to becoming the healthiest state in the nation.”

“The Colorado Attorney General’s Office is proud to have contributed $1 million in seed money to support the Consortium’s work,” said Attorney General Cynthia Coffman. “It is fitting that funds from settlements with major pharmaceutical companies to resolve charges of misconduct are now being spent to combat Colorado’s prescription drug abuse problem.”

The University of Colorado Skaggs School of Pharmacy on the Anschutz Medical Campus serves as the Coordinating Center and headquarters for the Consortium. The aim is for the Consortium to meet specific quarterly goals in each of the six work group areas and produce a specific Colorado Plan in one year. The Colorado VNA is proud to be a public awareness advocate for this important cause.

Did you know?
• Nearly 224,000 Coloradans misuse prescription pain relievers each year. Prescription drug safety starts with you and asking questions of your physician and pharmacist.
• One out of every six of Colorado’s 12th graders has taken a prescription that wasn’t theirs. Keep your family safe and talk to your kids about the right way to use prescription medicine. Visit TakeMedsSeriously.org for safety tips and much more.
• In 2013, almost 50 Coloradans died each month from unintentional drug poisonings. Safe prescription medicine use starts with you.
• Almost half of all Coloradans have unused or expired prescription drugs in their medicine cabinets at home that can be abused. You don’t need them, so get rid of them. Learn the best way to dispose your prescription medicine at TakeMedsSeriously.org.
• 42 percent of teens who’ve misused or abused prescription drugs got them from their parents’ medicine cabinet. Have you locked up your medicine? Keep your children safe.
Start an ongoing conversation with your kids about the subject. SpeakNowColorado.org is a comprehensive website for parents that provides guidance on how to address prescription drugs, and other substances, with their children.
• There are resources in our state to help with addiction. Several agencies around the state offer help with addiction or dependency. Go to http://takemedsseriously.org/safe-use/abuse/recreational-use/ to find help near you.

To learn more about the Colorado Consortium for Prescription Drug Abuse Prevention, visit its website and Save the Date for the group’s annual meeting this fall on October 15, 2015.

Immunization Protects All of Us: Don’t Wait. Vaccinate!

August is National Immunization Awareness Month

August is National Immunization Awareness Month

August is National Immunization Awareness Month. In the United States, vaccines have greatly reduced infectious diseases that once routinely killed or harmed many infants, children, and adults. However, the viruses and bacteria that cause vaccine-preventable disease still exist and can be passed on to people who are not protected by vaccines. Every year, thousands of Americans still suffer serious health problems, are hospitalized, and even die from diseases that could be prevented by vaccines. Protect your health and the health of your family. Make sure you and your loved ones are up-to-date on recommended vaccines.

Here’s why you shouldn’t wait:
• Many vaccine-preventable diseases are still common in the U.S.
• Those that are not common here are still found in other parts of the world, and can still be a threat.
• Some of these diseases are very contagious.
• Any of these diseases could be serious – even for healthy people.
• Certain people may be at higher risk for getting some diseases or having more serious illness if they were to get sick, like young children, older adults, and those with health conditions.

Vaccines are our best protection against a number of serious, and sometimes deadly, diseases. Every year, the Centers for Disease Control and Prevention (CDC) and other medical experts update vaccine recommendations for children, teens, and adults based on the latest research and evidence-based science on vaccine safety, effectiveness, and patterns of vaccine-preventable diseases.

You have the power to protect yourself and the ones you love. Talk to your healthcare professional about which vaccines are right for you and your family.

Getting Vaccinated
Most private health insurance plans cover the cost of recommended vaccines. The Vaccines for Children (VFC) Program helps provide vaccines to children whose parents or guardians may not be able to afford them. Medicare and Medicaid also cover a number of vaccines for adults. Vaccines are available at private doctor offices, as well as other convenient locations such as pharmacies, workplaces, community health clinics, and health departments.

To learn more about vaccines and take a quick quiz to find out which vaccines you may need, visit: www.cdc.gov/vaccines/adults

The Colorado VNA has begun early booking for flu immunization clinics this fall.  To reserve your preferred date, be sure to call us at 303-698-2121 to get your flu clinic on your calendar.  We also offer an online booking option.  Just click here and one of our Wellness team members will get back to you right away.