Post-Acute Care Workgroup Examines “Hard to Place” Patients
As the State continues its implementation of the Total Cost of Care Model, the Maryland Department of Health has assembled a workgroup to examine challenges with hospital discharges for complex and often repeat patients as a challenge to both the cost containment pressures relative to the Model and to population health outcomes. Challenges discussed have related to the delays in obtaining guardianship as well as the clinical needs of certain patient populations, such as behavioral health, bariatric, patients with high-cost medication needs. A subset of this group will be meeting at the end of this month to more closely examine the ability to address some of these issues through a care redesign program. LifeSpan representatives have been actively participating in these discussions.
Nursing Facility Liaison Meeting Updates
- Pay-for-Performance: During the 2019 Session, the General Assembly added budget language that required the Maryland Department of Health to increase the allocation of Maryland’s pay-for-performance program and to re-examine the quality measures. While no changes will be occurring this year, the following changes are anticipated or being discussed for Calendar Year 2020 – 1) doubling of the allocation to 1% of total nursing facility reimbursement; 2) using the new family satisfaction survey that has been updated and will be released to resident family members; 3) removing of the points for the infection control coordinator, given that it is a regulatory requirement; points will be reallocated; 4) re-evaluation of quality measures, specifically the potential for including falls as a measure; and 5) the use of PBJ rather than the salary survey (in addition, a brief questionnaire will be added related to retention).
- Duals ACO: During the 2019 Session, the General Assembly instructed the Maryland Department of Health to examine the development of an Accountable Care Organization for the dually-eligible. To date, no discussions have taken place on this requirement.
- Rebasing: The Maryland Department of Health will begin rebasing rates using Calendar Year 2018 rather Calendar Year 2016.
- TPL: Under the new contract next year, TPL audits will be completed annually.
- Redistricting Phase II: For nursing realignment, Phase II will be implemented for Calendar Year 2021
Regulatory Update
- As a reminder, the nursing facility regulations went into effect on June 17th. A complete copy of the updated regulations can be accessed online.
- The Office of Health Care Quality has not yet commenced its work on the assisted living regulations.