New Home Health Conditions of Participation Rule: Are You Ready?

Jan 19, 2017 2:33:28 PM

The newly updated Home Health Conditions of Participation (CoPs) rule, effective July 13, 2017, aims to strengthen patients’ rights, facilitate communication among caregivers, and improve the quality of home health services. How will these revisions affect the way your home care agency communicates and delivers services?

The Impetus for Change

With approximately 12,600 home health agencies providing services to roughly 5 million Medicare and Medicaid beneficiaries in the United States, the Centers for Medicare & Medicaid Services (CMS) has long sought a solution to establish consistent levels of quality of care across its health care programs.

For the past 20+ years, this has primarily involved setting minimum-level standards and targeting health care providers that delivered substandard care.

Revised CMS Home Health Conditions of Participation Rule: Implications for AgenciesUnfortunately, this problem-centered approach focused on improving the program’s most inadequate partners. Agencies risked being terminated from Medicare or Medicaid programs if they fell short of standards and couldn’t make documented corrections. As a result, like teachers teaching to a test, agencies found themselves dedicating their time and effort to meeting the standards rather than actually improving patient care.

Revisions to the current rule have been desperately needed, not only to keep pace with industry developments over the last two decades, but to achieve the far-reaching, measurable improvements CMS seeks.

Through extensive research, discussion and revision, CMS determined the new CoPs should focus on what it calls “a patient-centered, data-driven, outcome-oriented process that promotes high quality patient care at all times for all patients.”

What Changes Has CMS Made to the Rule?

CMS considered a range of factors, including home care industry developments, governmental agency and medical insights, industry expert recommendations, and public comments. The resulting modified rule truly modernizes the CoPs and sets the stage for significant improvements in care delivery and patient services.

In general, the new requirements aim to improve the flexibility and performance of home health agencies while increasing both patient satisfaction and desired patient outcomes.

Specifically, changes to the CoPs include:

  • Requiring agencies to implement an integrated communication system (including secure electronic communications) to identify and address patient needs, coordinate care across disciplines of providers, and ensure active communication between the agency and the patient’s physician
  • Encouraging home health agencies to adopt integrated, patient-centered care processes
  • Eliminating procedural requirements that don’t improve patient outcomes
  • Incorporating an interdisciplinary approach to patient care that integrates the skills of a range of health professionals
  • Developing measurable assessment and performance improvement programs that evaluate and improve care
  • Expanding the patient care coordination requirement, making a licensed clinician responsible for all aspects of patient care
  • Clearly stating and safeguarding patient rights

What Do the Revised CoPs Mean for Home Health Agencies?

The CoPs changes now more accurately reflect health care’s evolving stance on care coordination and the new opportunities today’s technology solutions create. As a result, home care agencies can return to doing what they do best: providing the level of care their patients need.

When the new rule goes into effect this summer, your agency must be ready to:

  • Use an integrated communication system that ensures all caregivers can stay connected on the status of a patient’s care. Are you using mobile technology that allows for real-time communication between caregivers in the field? Can that technology also support the participation of patients and their families?
  • Streamline operational and clinical procedures to help staff focus on providing quality care and complying with the new regulations. When agencies automate back-office workflows and enable data collection at the point of care, client visits are updated immediately. This reduces the risk of paperwork falling through the cracks, and maintaining the most up-to-date patient records can contribute to better care decisions and improved patient outcomes.
  • Identify and implement performance improvement programs that can improve care and client satisfaction. Incorporating a care delivery management solution that includes electronic visit verification may help your agency improve reporting capabilities, facilitate the data collection process, and improve the efficiency and quality of the care delivered.

With fewer than six months to incorporate these changes, agencies must be prepared to meet these new communication and patient care standard requirements. Is your agency ready?

Keep pace with the changing landscape of patient care by optimizing outcomes, increasing productivity, and helping your bottom line — all while meeting the new CoPs guidelines. Contact CellTrak today to learn how our solutions can help you confidently comply with new regulations and improve patient care.

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Topics: Compliance