IPS not as disruptive as industry claims
A report released by the Department of Health and Human Services’ Office of Inspector General refutes industry claims that the interim payment system (IPS) has led to major disruptions in access to home care for Medicare beneficiaries.
The report — Medicare Beneficiary Access to Home Health Agencies — found that 85% of hospital discharge planners surveyed reported that Medicare patients were able to obtain home health services, while another 15% reported that home health care was not always available.
"Hospital discharges to home health care appear to remain constant," the report concluded. "The proportion of Medicare discharges to home healthcare were 11% in the first six months of 1999."
But home health industry advocates countered by saying that the report actually substantiated their arguments that major disruptions have occurred. "I thought their headlines were misleading and did not reflect what are the most significant findings in the report, said Jim Pyles, counsel for Home Health Services and Staffing Association in Jacksonville, FL, in a statement.
Pyles cited data in the study that showed half of discharge planners found that the sickest patients were being denied access to care. He noted 25% of discharge planners reported that home health patients were not getting the care they required as evidenced by re-hospitalizations and increased admissions to emergency rooms.
Report determined how IPS affected access
The report was designed to determine how IPS has affected access to care. "The industry has painted a picture that IPS has decimated home health and beneficiaries can’t get care," said an OIG spokesperson. "Our survey of the hospital discharge planners shows that the overwhelming majority of Medicare beneficiaries who need home health services after being discharged from the hospital are being placed."
But a George Washington University study contradicts OIG findings. In mid-November, its researchers released the second phase of an IPS study that looked at the impact of the new reimbursement method. According to the study, 63.5% of hospital discharge planners reported increased difficulty in initial placement of Medicare beneficiaries into home care. About half of the hospitals surveyed estimated increases in hospital lengths of stay resulting from these difficulties.
The discharge planners who were surveyed said the difficulties usually were associated with short-term, high-intensity needs — patients requiring two visits per day, complex wound care, and among patients with chronic illnesses.
• Chandra Branham, Associate Director of Regulatory Affairs, National Association for Home Care, 228 Seventh St. S.E., Washington, DC 20003. Telephone: (202) 547-7424.
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