Health agency vies for home health boost

The Southwestern Connecticut Agency on Aging is teaming up with three area hospitals to apply for the new Community-based Care Transitions Program (CCTP), which would dispatch nurses into the field to assist seniors with medical and lifestyle issues after they leave the hospital.

The federal Centers for Medicare and Medicaid Services (CMS) is awarding $500 million nationally under the Care Transitions Program, which was authorized under the Affordable Care Act to cut down on the rate of hospital readmissions ”“ estimated at one in five seniors heading back to the hospital within a month, at a cost of $26 billion a year.

Under the existing Medicare home health benefit program, seniors can get coverage for skilled nursing in the home for up to two months for any single “episode of care” in CMS parlance.

Norwalk Hospital, Stamford Hospital and St. Vincent”™s Medical Center in Bridgeport along with the Southwestern Connecticut Agency on Aging are vying for CCTP funding under the program, which will address both transitions to skilled nursing facilities as well as to seniors”™ residences, which have skilled nurses and home health aides.

That latter group is coming under intense pressure in the wake of the U.S. Supreme Court upholding most components of the Affordable Care Act, according to an analyst with Stamford-based CRT Capital.

“With the Supreme Court”™s decision leaving the bulk of reform in place, home health companies cannot expect to get relief from the nearly crushing pressure on volumes from the face-to-face and therapy assessment portions of that law,” wrote CRT analyst Sheryl Skolnick, in a note to clients cited by The Wall Street Journal.

Despite the increased burdens posed under health reform, the number of home health care agencies nationally spiked 20 percent last year, according to the Medicare Payment Advisory Commission, with MedPac advising Congress. Today, the National Association of Home Care and Hospice has 33,000 members total, including its chairman Robert J. Simione who runs Simione Healthcare Consultants L.L.C. in Hamden, with its specialties include advice on mergers and acquisitions. The trade group held its annual financial management conference last week in Dallas, with changes to the Medicare home health benefit at the top of the agenda.

In a 100-page study published in April by Genworth Financial Inc. and CareScout, the companies found there was no change in the cost of home health care nationally between 2011 and 2012.

The median cost for home health services in Connecticut was $21 an hour, just $2 above the national average. Home health care services have risen at an annual 1 percent inflation rate over the past five years; Genworth and CareScout attributed the flat prices in part to increased competition and a favorable labor market.

Ranked by total annual expenditures, Connecticut”™s median cost of a home health care worker was second lowest in the Northeast after New Jersey, though still well above the U.S. median of $43,500.

The cost for community adult day health care services was $19,000 in Connecticut, higher than most Northeast neighbors.

Those figures compared with a median private nursing room in Connecticut totaling $149,000 on an annualized basis, with the annual rate of increase at more than 4 percent.

With other states, Connecticut is experimenting with a Money Follows the Person pilot program that targets available dollars to less-expensive settings such as home- and community-based care.

“The median cost for home health services in Connecticut was $21 an hour, just $2 above the national average. Home health care services have risen at an annual 1 percent inflation rate over the past five years; Genworth and CareScout attributed the flat prices in part to increased competition and a favorable labor market.”