COVID Vaccine Rollout for Older People: East Meets West

Abstract Older adults should be one of the first groups to receive COVID-19 vaccines, because the risk of dying from COVID-19 increases with age. However, it takes time to distribute the vaccines to different countries, and the challenges in administering vaccines may differ by health system characteristics and local culture. This international symposium will discuss the vaccine rollout issues in eight countries (Isreal, Japan, South Korea, China, France, United Kingdom, Canada, and United States). We will use an interview and dialog format, instead of presentations. We will cover extensive topics including: Availability - What vaccines? Access, Acceptance, Caregivers – How are providers responding/handling caregivers wanting to be vaccinated?Cost/Financing Issues, Distribution Logistics/Transport/Safety, Lessons Learned, Mutations/Variants, Partnerships needed to vaccinate homebound patients (community partners; home health agencies, etc.), Who can/should provide vaccination? The situation with COVID-19 is still very fluid. Countries are at different stages of vaccinating older people. The chair didn't ask the speakers to write an abstract now, instead, the speakers will collect more information during the next few months and plan to have a prep meeting one month before the Annual Meeting.

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Inequities in Access to High-Quality Home Health Agencies Among Racial and Ethnic Minorities With and Without Dementia

Innovation in Aging ◽

10.1093/geroni/igab046.1276 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 330-330

Author(s):

Bei Wu ◽

Abraham Brody ◽

Chenjuan Ma

Keyword(s):

Ethnic Minorities ◽

Home Health ◽

High Quality ◽

Racial And Ethnic Minorities ◽

Black And White ◽

Percentage Points ◽

Health Agencies ◽

Home Health Agencies ◽

Race Ethnicity ◽

To Receive

Abstract There are rising concerns of inequities in access to high-quality home health agencies (HHA). Using multiple national data sources that included 574,682 individuals from 8,634 HHA, we examined access to high-quality HHA care among racial and ethnic minorities with and without dementia. Approximately 9.9% of the individuals were Black, 6.2% Hispanic, and 3.3% other race/ethnicity. Over one-third (36.3%) had been diagnosed with dementia. Black and Hispanic individuals were 5.5 percentage points (95% CI, 5.2% - 5.9%) and 7.4 percentage points (95% CI, 7.0% - 7.8%) respectively more likely to receive care from agencies defined as having low-quality compared to White counterparts. Persons living with dementia were 1.3% less likely to receive care from high-quality agencies. Having dementia increased the inequity in accessing high-quality HHA between Black and White individuals. Racial and ethnic minorities, particularly those with dementia were at a disadvantaged position to receive care from high-quality HHA.

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Home Health Agencies: Empirical Evidence on the Patient-Driven Groupings Model’s Expected Effects on Agency Reimbursements

Home Health Care Management & Practice ◽

10.1177/1084822321990382 ◽

2021 ◽

pp. 108482232199038

Author(s):

Elizabeth Plummer ◽

William F. Wempe

Keyword(s):

Ordinary Least Squares ◽

Process Quality ◽

Home Health ◽

Least Squares Regression ◽

Residual Variation ◽

Health Agencies ◽

Dual Eligible ◽

Home Health Agencies ◽

Seriously Ill Patients ◽

Seriously Ill

Beginning January 1, 2020, Medicare’s Patient-Driven Groupings Model (PDGM) eliminated therapy as a direct determinant of Home Health Agencies’ (HHAs’) reimbursements. Instead, PDGM advances Medicare’s shift toward value-based payment models by directly linking HHAs’ reimbursements to patients’ medical conditions. We use 3 publicly-available datasets and ordered logistic regression to examine the associations between HHAs’ pre-PDGM provision of therapy and their other agency, patient, and quality characteristics. Our study therefore provides evidence on PDGM’s likely effects on HHA reimbursements assuming current patient populations and service levels do not change. We find that PDGM will likely increase payments to rural and facility-based HHAs, as well as HHAs serving greater proportions of non-white, dual-eligible, and seriously ill patients. Payments will also increase for HHAs scoring higher on quality surveys, but decrease for HHAs with higher outcome and process quality scores. We also use ordinary least squares regression to examine residual variation in HHAs’ expected reimbursement changes under PDGM, after accounting for any expected changes related to their pre-PDGM levels of therapy provision. We find that larger and rural HHAs will likely experience residual payment increases under PDGM, as will HHAs with greater numbers of seriously ill, younger, and non-white patients. HHAs with higher process quality, but lower outcome quality, will similarly benefit from PDGM. Understanding how PDGM affects HHAs is crucial as policymakers seek ways to increase equitable access to safe and affordable non-facility-provided healthcare that provides appropriate levels of therapy, nursing, and other care.

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Is Health Information Exchange Use by Hospitals and Home Health Agencies Associated with Lower Readmission Rates?

Innovation in Aging ◽

10.1093/geroni/igaa057.3360 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 914-914

Author(s):

Christine Jones ◽

Jacob Thomas ◽

Marisa Roczen ◽

Kate Ytell ◽

Mark Gritz

Keyword(s):

Health Information ◽

Information Exchange ◽

Transitional Care ◽

Care Transitions ◽

Home Health ◽

Hospital Length Of Stay ◽

Care Hospital ◽

Readmission Rates ◽

Health Agencies ◽

Home Health Agencies

Abstract For older adults transitioning from the hospital to home health agencies (HHAs), clinical information exchange is key for optimal transitional care. Hospital and HHA participation in regional health information exchanges (HIEs) could address fragmented communication and improve patient outcomes. We examined differences in characteristics and outcomes for patients with either Medicare or Medicare Advantage (MA) insurance who transitioned from hospitals to HHAs based on HIE participation with 2014-2018 data from the Colorado All Payer Claims Database. We performed analyses including chi square and t tests to compare patient characteristics and 30-day readmission rates for high versus lower HIE use, determined by HIE participation (+) and non-participation (-) among HHAs and hospitals: High HIE use dyads (Hospital+/HHA+) were compared to lower HIE use dyads (Hospital+/HHA-, Hospital-/HHA+, Hospital-/HHA-). We identified 57,998 care transitions from 123 acute care hospitals to 71 HHAs. On average, patients were 75 years old, had a three day hospital length of stay, over half were female (58%), 82% had Medicare and 18% had MA insurance. Although most characteristics were similar between high versus lower HIE use dyads, high HIE use dyads had a higher proportion of Medicare patients compared to the lower HIE use dyads (85% vs 79%, p <0.001). Thirty-day readmissions were 12.4% for care transitions that occurred among high HIE use dyads (n=27,784) compared to 12.8% among lower HIE use dyads (n=32,929, p=0.102). For adults transitioning from hospitals to HHAs among high HIE use dyads, a trend toward lower 30-day readmission rates was identified.

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Disaster Preparedness for Vulnerable Persons Receiving In-Home, Long-Term Care in South Carolina

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00005744 ◽

2008 ◽

Vol 23 (2) ◽

pp. 133-142 ◽

Cited By ~ 22

Author(s):

Sarah B. Laditka ◽

James N. Laditka ◽

Carol B. Cornman ◽

Courtney B. Davis ◽

Maggi J. Chandlee

Keyword(s):

Health Care ◽

South Carolina ◽

Home Health Care ◽

Disaster Planning ◽

Home Health ◽

Personal Care ◽

Term Care ◽

Care Services ◽

Health Agencies ◽

Home Health Agencies

AbstractPurpose:The purpose of this study was to examine how agencies in South Carolina that provide in-home health care and personal care services help older and/or disabled clients to prepare for disasters.The study also examines how agencies safeguard clients' records, train staff, and how they could improve their preparedness.Methods:The relevant research and practice literature was reviewed. Nine public officials responsible for preparedness for in-home health care and personal care services in South Carolina were interviewed. A telephone survey instrument was developed that was based on these interviews and the literature review. Administrators from 16 agencies that provide in-home personal care to 2,147 clients, and five agencies that provide in-home health care to 2,180 clients, were interviewed. Grounded theory analysis identified major themes in the resulting qualitative data; thematic analysis organized the content.Results:Federal regulations require preparedness for agencies providing inhome health care (“home health”). No analogous regulations were found for in-home personal care. The degree of preparedness varied substantially among personal care agencies. Most personal care agencies were categorized as “less” prepared or “moderately” prepared. The findings for agencies in both categories generally suggest lack of preparedness in: (1) identifying clients at high risk and assisting them in planning; (2) providing written materials and/or recommendations; (3) protecting records; (4) educating staff and clients; and (5) coordinating disaster planning and response across agencies. Home health agencies were better prepared than were personal care agencies.However, some home health administrators commented that they were unsure how well their plans would work during a disaster, given a lack of training. The majority of home health agency administrators spoke of a need for better coordination and/or more preparedness training.Conclusions:Agencies providing personal care and home health services would benefit from developing stronger linkages with their local preparedness systems. The findings support incorporating disaster planning in the certification requirements for home health agencies, and developing additional educational resources for administrators and staff of personal care agencies and their clients.

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Increasing Home Health Face-to-Face Certification: Impact of a Hospital-Based Intervention

Home Health Care Management & Practice ◽

10.1177/1084822317749477 ◽

2018 ◽

Vol 30 (3) ◽

pp. 110-115

Author(s):

Kimberly Pelland ◽

Emily Cooper ◽

Alyssa DaCunha ◽

Kathleen Calandra ◽

Rebekah Gardner

Keyword(s):

Chart Review ◽

Retrospective Chart Review ◽

Home Health ◽

Hospitalized Patients ◽

Post Intervention ◽

Face To Face ◽

Hospital Physicians ◽

Health Agencies ◽

Community Physician ◽

Home Health Agencies

Medicare requires that home health patients have a face-to-face visit with a physician when services are initiated and that physicians provide certification of this encounter before home health agencies (HHAs) can be reimbursed. We assessed an intervention to increase completion of face-to-face certification by hospital physicians at discharge using a retrospective chart review. We found a shift in the source and timeliness of certification among intervention hospitals. Pre-intervention, hospital physicians completed face-to-face certifications for 18.7% of patients and community physicians completed certifications for 47.2% ( p < .001), compared with 44.4% and 24.3% ( p < .001) post-intervention. Shifting the source of certification from community to hospital physicians helped HHAs by reducing the burden of tracking down certification from community physician offices and facilitating timely care for recently hospitalized patients.

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Home Health Agencies Can Now Bill Medicare Separately for Furnishing New Disposable Negative-Pressure Wound Therapy Devices

Advances in Skin & Wound Care ◽

10.1097/01.asw.0000513600.75792.01 ◽

2017 ◽

Vol 30 (4) ◽

pp. 154-156 ◽

Cited By ~ 1

Author(s):

Kathleen D. Schaum

Keyword(s):

Negative Pressure ◽

Negative Pressure Wound Therapy ◽

Home Health ◽

Wound Therapy ◽

Health Agencies ◽

Home Health Agencies

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Home Health Agencies

The Law of Tax-Exempt Healthcare Organizations ◽

10.1002/9781118646243.ch10 ◽

2013 ◽

pp. 293-302

Keyword(s):

Home Health ◽

Health Agencies ◽

Home Health Agencies

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“You get three different hats on and try to figure it out:” home based care provision during a disaster

BMC Nursing ◽

10.1186/s12912-021-00676-2 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Sue Anne Bell ◽

Sarah Dickey ◽

Marie-Anne Rosemberg

Keyword(s):

Older Adults ◽

Health Care ◽

Focus Groups ◽

Home Health ◽

Care Provision ◽

Care Providers ◽

Home Based ◽

Health Agencies ◽

Home Health Agencies ◽

Home Based Care

Abstract Background Home based care is a vital, and growing, part of the health care system that allows individuals to remain in their homes while still receiving health care. During a disaster, when normal health care systems are disrupted, home based care remains a vital source of support for older adults. The purpose of this paper is to qualitatively understand the barriers and facilitators of both patients and providers that influence the provision of home based care activities in two hurricane affected communities. Methods Using qualitative inquiry informed by the social ecological model, five focus groups were conducted with home based care providers (n = 25) in two settings affected by Hurricane Irma and Hurricane Harvey. An open-source database of home health agencies participating in Centers for Medicare and Medicaid Services programs was used to identify participants. Data were manually coded and larger themes were generated from recurring ideas and concepts using an abductive analysis approach. Results Twenty five participants were included in one of five focus groups. Of the 22 who responded to the demographic survey, 65 % were registered nurses, 20 % were Licensed Vocational Nurses (LVN), and 15 % were other types of health care providers. 12 % of the sample was male and 88 % was female. Five themes were identified in the analysis: barriers to implementing preparedness plans, adaptability of home based care providers, disasters exacerbate inequalities, perceived unreliability of government and corporations, and the balance between caring for self and family and caring for patients. Conclusions This study provides qualitative evidence on the factors that influence home based care provision in disaster-affected communities, including the barriers and facilitators faced by both patients and providers in preparing for, responding to and recovering from a disaster. While home based care providers faced multiple challenges to providing care during and after a disaster, the importance of community supports and holistic models of care in the immediate period after the disaster were emphasized. We recommend greater inclusion of home health agencies in the community planning process. This study informs the growing body of evidence on the value of home based care in promoting safety and well-being for older adults during a disaster.

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