28th Annual Home Care and Hospice Conference and Exposition

We were delighted to attend the 28th Annual Home Care and Hospice Conference and Exposition in Los Angeles this year.  Our new booth was on display and we enjoyed talking with many visitors about our point of care system, iPOC, and introducing our new EMR product, Igea EMR, due for release in Q1 2010.

Many existing Igea customers visited us to share their delight with Igea HHC, and to offer us valuable feedback on features and functions they would like to see in future releases.  All this information is carefully documented and passed to our research and development team.

A number of visitors asked us about OASIS-C and ICD10 and we were happy to reassure them that our entire product line will remain compliant through all future changes to these standards.

Janet Rosta from the Baptist Memorial Health Care Corporation in Tennessee was the lucky winner of our Dell Mini 10 Netbook, a special prize awarded to all those who visited our booth and could answer 5 questions about Indura Systems and Igea HHC.  Congratulations to Janet.

A new newsletter will be distributed soon and will include some exciting updates and screen shots of our trade show attendance, and our Igea EMR beta release.

President Obama Makes Health Care Reform a Top Priority

March 03, 2009 - by Lynn Shapiro, Writer

The Senate is pitched for battle, having heard the details of President Obama's plans for health care reform, laid out in the speech he delivered to Americans last week.

It is a certainty that every vested interest will lobby against it, especially pharmaceutical companies, which stand to lose huge sums of money now that the Obama administration plans to spend $1.1 billion for new reviews of generic drugs. The move is based on several recent studies showing that generics sometimes work as well or better than newer, more expensive medicines. The budget also calls for negotiations with drug makers to lower their prices, as Canada and Western European countries now do.

This initiative is a radical departure from President George W. Bush's Prescription Drug Plan of 2003 for Medicare beneficiaries (Medicare Part D), which refused to require drug makers to negotiate their prices downward.

Unlike Bush, Obama appears unafraid of impinging on the fortunes of industry. Neither is he averse to taxing Americans in the highest income bracket. The President said that most workers are unduly constrained by health care costs and that to ease this burden, he would derive $318 billion by raising the taxes on the top 20 percent of tax filers who earn more than $250,000 a year. These individuals would pay 90 percent of all taxes.

Obama's proposal would also eliminate subsidies now given to the private plans that provide care to more than 10 million of the 44 million Medicare beneficiaries. By forcing these plans, known as Medicare Advantage, into a competitive bidding process, the administration says it can save $175 billion over the next 10 years.

The President is counting on the economy to be thriving by 2011. Then, his plan for hiking taxes on high-income payers would make it possible for him to keep his promise to halve the deficit by 2013.

Deficits of almost $1.8 trillion in 2009 and $1.2 trillion in 2010 are frightening. But while Obama wants to extend tax cuts for the middle class, much of the health care package is intended to save the economy and create jobs. So, the massive amount of red ink Americans face should be temporary, the budget assumes.

Deciding when to go from stimulus spending to deficit reduction is the trickiest part of the equation, but doing it is essential, analysts say.

Other Provisions

Another avenue for health care savings would come from slashing Medicare's home health care programs, said to be excessive. What's more, ending rebates from drug companies for medicines sold to Medicaid patients would save the U.S. healthcare system almost $20 billion.

The budget also includes more than $1 billion to help the FDA fortify its food safety program because of the salmonella outcry; $6 billion for cancer research and a program to send nurses to new mothers' homes to check on babies. Another $76.8 billion would go to the Health and Human Services Department to fund electronic medical records to end costly duplication of diagnostic tests and allow doctors to share patient histories. This provision is not only cost-effective but potentially beneficial to the patient, experts say. Obama promises to preserve patients' privacy, even while doctors share patients' records.

White House budget director Peter Orszag projected in commentary over the weekend that the proposed spending would save $1.8 billion in 2010, $16.2 billion in 2011 and increasing amounts annually to create a $633.8 billion fund to pay for health care reform by 2018. Congress has already provided $25 billion to help laid-off workers pay for COBRA.

What's more, Obama says that spending to get coverage for more of America's 46 million uninsured will save money, if preventive care helps patients avoid expensive and chronic diseases.

Money will be also be saved, Obama said, by finding and eliminating overpayments in Medicare. "The Government Accountability Office has labeled Medicare as 'high-risk' due to billions of dollars lost to overpayments and fraud each year," the budget reads.

Better Care, Not More

In conclusion, the budget says "about $26 billion can be saved over 10 years by using a combination of incentives and penalties to prevent avoidable expensive readmission when patients go back into the hospital within a month after treatment. Reforming the way doctors are paid will also reduce costs, by paying them to provide better care rather than more expensive care, such as imaging scans and surgery that may not be necessary." For example, since Obama took office, Medicare has announced it will stop covering virtual colonoscopies, deciding they're too expensive.

None of this will be easy but one thing is for sure. President Obama has made health care reform a top priority.

Brought to you by Indura Systems.

House Call Physicians Ineligible for e-Prescribing Incentives

AAFP Efforts Fail to Reverse CMS Decision
By Sheri Porter 2/24/2009

The AAFP's efforts, in tandem with those of the American Academy of Home Care Physicians, or AAHCP, to correct an oversight in CMS' recently launched electronic-prescribing incentive program, recently resulted in a denial from the agency.

Rick Kellerman, M.D., of Wichita, Kan., an AAFP past president, is shown here checking on a nursing home patient.

In a Feb. 9 letter to CMS Acting Administrator Charlene Frizzera, AAFP Board Chair Jim King, M.D., of Selmer, Tenn., pointed out that, as currently implemented by CMS, Section 132 of the Medicare Improvements for Patients and Providers Act of 2008 "precludes physicians who practice predominantly, if not exclusively, as house call physicians from participation in the e-prescribing incentive program." On Feb. 23, however, AAFP News Now learned from AAHCP Executive Director Constance Row that CMS had declined to make the changes recommended by the two organizations.

Relevant CPT Codes Overlooked

The issue lies with the agency's choice of CPT codes that appear in the denominator of the e-prescribing legislation. As King pointed out in his letter to CMS, those CPT codes include services provided in the areas of psychotherapy, general ophthalmological services, health and behavior assessment and intervention, office and outpatient visits, and office consultations. However, CMS failed to include codes typically used by physicians who focus their practices on house call services, said King.

Those codes also include care provided to patients living in nursing homes. King argued that many house call physicians were early adopters of health information technology and e-prescribing. He said patients served by home care physicians usually have multiple comorbidities that call for an array of prescriptions that would be more efficiently handled electronically.According to Row, however, "CMS has decided definitively not to add these codes to the 2009 electronic-prescribing incentive program." She added that the letter from CMS indicated the agency may "consider changes for 2010 or beyond."

Statistics Reinforce Call for Inclusion

Row said that statistics provided by CMS only reinforce the argument that home health care physicians and other eligible providers should have the opportunity to benefit financially from the e-prescribing bonus program. She cited figures from CMS' Physician Supplier Procedure Summary Master Record that details Part B claims paid by Medicare carriers in 2007.According to those data, all Medicare providers combined logged 2,194,083 total house calls and 1,696,411 total domiciliary visits (i.e., house calls to patients residing in assisted living facilities) in 2007.

Family physicians alone logged 410,582 house call visits and 286,521 domiciliary visits in 2007. In his letter, King called on CMS to add home services CPT codes 99341 to 99350 and domiciliary/rest home visit CPT codes 99324 to 99337 to the denominator for eligibility in the e-prescribing incentive program.Row said that in light of CMS' rejection of that suggestion, her organization would continue to work closely with the AAFP for possible resolution of the issue in 2010.

Brought to you by Indura Systems.

Obama releases $15 billion in Medicaid funding to states

President Obama, meeting with the nation's governors in Washington, D.C., this morning, announced a quick release to the states of $15 billion of federal Medicaid relief funding to help them cope with the rising health care costs brought on by the economic crisis. According to a White House press release, the money will be available in 48 hours--on Wednesday--in special Treasury accounts set up for the states to access.

"That means that by the time most of you get home," said President Obama, "money will be waiting to help 20 million vulnerable Americans in your states keep their health coverage. Children with asthma will be able to breathe easier, seniors won’t need to fear losing their doctors, and pregnant women with limited means won’t need to worry about the health of their babies.”

The funding is part of the designated moneys from the American Recovery and Reinvestment Act, and the temporary increase will be administered by the Department of Health and Human Services’ Centers for Medicare & Medicaid Services (CMS). The federal agency will coordinate with states to ensure they are properly meeting regulations and requirements about Medicaid.

The announcement of the funding release was made as President Obama and Vice President Biden hosted members of the National Governors Association at the White House.

A state-by-state grant award summary for the program can be found here.

SusanG@dailykos.com

Brought to you by Indura Systems.

Care Givers on Bikes!

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Home health care benefits both taxpayers and patients

As Gov. David Paterson tries to make New York State's budget ends meet, he is met with cry after cry -- ''You can't cut my program!''

We've all seen the heart-rending ads on TV. There's one proposed cut, however, that doesn't make sense even for the people it least affects directly: home health care.

The governor wants to cut Medicaid reimbursement rates between 1.5 percent and 3.5 percent for certified home health agencies and long term home health care programs; he's also proposing an additional, across-the-board cut of 1 percent in all Medicaid rates, the elimination of an inflation-based increase in payments to home health providers for 2008 and 2009, and a 0.7 percent tax on revenues.

The Home Care Association of New York State says these actions likely will force many home care providers to drastically reduce services or go out of business. And without the option of home care, people who have depended on it are likely to end up back in hospitals and nursing homes, where taxpayers will pick up a much larger Medicaid bill.

The governor figures his proposal will save the state $184 million in Medicaid costs in 2009-10; since the federal government contributes toward Medicaid, it means a cut of about $347 million in federal home health funding. Does Gov. Paterson think the people who no longer can get home health care are just going to disappear? Too many will need to be moved into more expensive hospitals and nursing homes. Home health care is less expensive, and provides better care, most experts agree. Why would we want to end a program that does that?

New York State's Medicaid program has been described as the ''Cadillac'' of programs, offering more coverage than most other states do. It is better coverage than many people can afford from private insurers, and better than the coverage offered by many employers. Shouldn't this be an area that could be looked at for cuts before threatening programs that actually save taxpayers money while providing better care for patients?

Neither the taxpayers nor the patients will be better off under these proposed budget cuts. We urge Gov. Patterson to reconsider.

Brought to you by Indura Systems.

What The Stimulus Plan Means to Healthcare

A comparison of the $838 billion economic recovery plan passed by the Senate with an $820 billion version passed by the House. Additional debt costs would add almost $350 billion over 10 years. Many provisions expire in two years.

From the Associated Press:

HEALTH CARE:

• Senate — $20 billion to subsidize health care insurance for the unemployed under the COBRA program; $87 billion to help states with Medicaid; $22 billion to modernize health information technology systems; $10 billion for health research and construction of National Institutes of Health facilities.


• House — $40 billion for more generous COBRA subsidies and to provide health care through Medicaid; $87 billion to help states with Medicaid; $20 billion to modernize health information technology systems; $4 billion for preventative care; $1.5 billion for community health centers; $420 million to combat avian flu; $335 million for programs that combat AIDS, sexually transmitted diseases and tuberculosis.

Brought to you by Indura Systems.

Good News from Palmetto - GBA RESOLUTION ACHIEVED

Claims Submitted through Direct Data Entry in Status/Location SM95HG

Palmetto GBA just announced that claims that were submitted through direct data entry (DDE) and are pending in FISS Status/Location SM95HG have been corrected and are being released for processing. These claims were submitted via DDE between November 3, 2008, and December 2, 2008 and received a duplicate document control number (DCN). PalmettoGBA is keenly aware this issue has affected sequential billing for some Home Health and Hospice providers. Once the affected claims begin to process to completion sequential billing can resume.

Previously issued accelerated payments are scheduled for recoupment beginning March 2, 2009.

To learn more about the resolution to this matter and others, we encourage you to visit the Palmetto GBA RHHI Claims Processing Issues Log located at this link.

Brought to you by Indura Systems.

Revised Home Health Prospective Payment System Fact Sheet

See the latest information at http://www.cms.hhs.gov/MLNProducts/downloads/HomeHlthProspPymtfctsht09-508.pdf.
Brought to you by Indura Systems.

Home Health Care - the business to start!

It's official - Home Health Care is one of few businesses that can survive the current economic crisis. Here is what the blog biziki.com has to say about Home Health Care:

While employment in the health service industry is projected to grow 28% by 2012, employment in the specialized home health care industry is expected to be
nearly twice that, or 54.5%. Each year, over 7.6 million people are provided with home health care services.

Thanks to science and medicine, people are living to a ripe old age more and more. This means, however, that more people are needed assistance at home. And that is where home health care comes into the picture.

Just think, 7.6 million people, 6 episodes per year, $3000 per episode - that is potentially a $136,800,000,000/year industry.
Want a bigger slice of that pie?
Find out why Igea HHC from Indura Systems is THE PREFERRED home health care agency management system for more customers throughout the United States.
Read the whole blog at http://www.biziki.com/biz/top-industries-to-start-a-business/.
Brought to you by Indura Systems.

NEWS RELEASE: Joint Commission - Jan 20, 2009

The Joint Commission to Include Patient Satisfaction Data on Quality Check™
Web site provides new information to help patients make decisions

(OAKBROOK TERRACE, Ill. – January 20, 2009) People seeking information about how patients perceive the care they received at a particular hospital can now find this information on The Joint Commission’s Quality Check™ Web site, http://www.qualitycheck.org/.

The Hospital Consumer Assessment of Health Providers and Systems (HCAHPS) data from the Centers for Medicare & Medicaid Services’ (CMS) Hospital Compare Web site is posted on Quality Check™ beginning this month. This information will be updated quarterly.

HCAHPS information comes from patient ratings of communication with doctors, communication with nurses, responsiveness of hospital staff, cleanliness and quietness of the hospital, pain management, communication about medications, and discharge information. In addition to information about patient satisfaction, Quality Check also includes data from CMS on 30-day mortality rates for heart attack, heart failure and pneumonia.

Thousands of people use Quality Check each month to find information about the more than 15,000 accredited health care organizations that have earned The Joint Commission “Gold Seal of Approval.” Quality Check provides details about an organization’s accreditation status, efforts to prevent medical mistakes by complying with National Patient Safety Goals, and comparison information about how hospitals comply with National Quality Improvement Goals such as giving heart attack patients aspirin within a specified timeframe.
Brought to you by Indura Systems

Introduction to Indura Systems

Home health care is one of the most regulated industries in the United States. Any organization that is associated with the health care industry is also open to aggressive litigation.

Any health care organization could spend considerable time understanding, and keeping track of, all the rules and regulations that apply, and are regularly being amended. With a fluctuating economy and shifts in age demographics, agencies are increasingly being expected to perform better with fewer resources.

Indura Systems understands the home health care industry from the agency perspective. Igea HHC, from Indura Systems, gives our customers the essential tools to achieve three things:

1. To focus on running their business effectively, and with lower overheads
2. To adhere to constantly changing regulatory controls including data security measures
3. To minimize time to reimbursement of payments from Medicare, Medicaid and/or Private Duty.

Igea HHC can deliver these benefits because the system has been built on a rugged, tested, and proven workflow model. The system is not only simple to use and easy to tailor to individual agency needs, but also helps maximize profit and shield agency staff from much of the complexity of home health care administrative tasks.

Contact us at Indura Systems to learn more about how we partner with home health care agencies to support and optimize their business success.