WASHINGTON, D.C - A Medicare rule intended to improve physician involvement and clinical integration with skilled home health care services is having negative health consequences for Medicare homebound patients. A new poll shows that the vast majority of physicians consider the rule will result in fewer patients referred to home care and that there will be a significant negative health consequences as a result. The cause of these problems is the unwieldy paperwork and documentation requirements that are part of the rule.
The rule of concern requires that Medicare home health care patients have a face-to-face encounter with a physician at the start of care. While the survey indicates that most physicians approve of the encounter requirement, they think that the extensive documentation requirements that are part of the rule are an unnecessary barrier to care. Under the rule, physicians must not only document that the encounter occurred, they must provide an unprecedented detailed narrative describing why the patient meets complex Medicare coverage standards. These extensive documentation requirements are in stark contrast with the simple lab test documentation proposal that Medicare recently rescinded because of concerns on its impact on care.
The survey was conducted by the independent polling firm, Fabrizio, Ward & Associates for the National Association for Home Care & Hospice (NAHC). Physicians in 49 states and DC responded over June 16-27, 2011.
Key findings of the survey include:
· 62% of physicians say patients are less likely to be referred to home health care because of the new documentation requirements
· 73% of the physicians say the documentation requirements will result in a negative impact on the health of Medicare
· 93% consider the face-to-face documentation requirements more burdensome than previous certification requirements and want them simplified
· While the physicians disapprove of the new paperwork requirements, 50% support keeping the face-to-face encounter requirement and simplifying the documentation
"At a time when we have a growing need for home health services to care for seniors as a cost-effective alternative to hospital and nursing facility care, erecting barriers to care through unnecessary physician paperwork does not make any sense," stated Val J. Halamandaris, president of NAHC. "A policy that was intended to increase physicians' involvement in the care of their patients at home is having the opposite effect. Medicare can do better than a rule that significantly adds to the already burdensome physicians' paperwork obligations. Doctors are great partners in home care, but not when they have to spend their time with documentation rather than patient care," Halamandaris added.
About NAHC
The National Association for Home Care & Hospice (NAHC) is a nonprofit organization that represents the nation's 33,000 home care and hospice organizations. NAHC also advocates for the more than two million nurses, therapists, aides and other caregivers employed by such organizations to provide in-home services each year to some 10 million Americans who are infirm, chronically ill, disabled and dying. Along with its advocacy, NAHC is committed to excellence in every respect and provides information to help its members maintain the highest quality of care. To learn more about NAHC, visit www.nahc.org and www.caring.org.