@article{0dcb6a06fbc4434e8262e1baa33946d6,
title = "Interactions between physicians and skilled home health care agencies in the certification of medicare beneficiaries' plans of care: Results of a nationally representative survey",
abstract = "Background: Physicians are required to certify a plan of care for patients who receive Medicare skilled home health care (SHHC) services. The Centers for Medicare & Medicaid Services form 485 (CMS-485) is typically used for certification of SHHC plans of care and for interactions between SHHC agencies and physicians. Little is known about how physicians use the CMS-485 or their perceptions of its usefulness with respect to coordinating care with SHHC agencies. Objective: To determine how physicians interact with SHHC agencies and use the CMS-485 in care coordination for patients receiving SHHC services. Design: Mailed survey. Setting: Nationally representative random sample. Participants: Physicians from the American Medical Association Physician Masterfile specializing in family or general medicine (excluding adolescent and sports medicine), geriatrics, geriatric psychiatry, internal medicine, or hospice and palliative medicine. Measurements: Time spent reviewing the plan of care and experiences with making changes and communicating with SHHC clinicians. Results: The response rate after 3 mailings was 53% (1044 of 1968). Of 1005 respondents who provided patient care, 72% had certified at least 1 plan of care in the past year. Nearly half (47%) reported spending less than 1 minute reviewing the CMS-485 before certification, whereas 21% reported spending at least 2 minutes. Physicians typically interacted with multiple SHHC agencies by fax or mail. Approximately 80% rarely or never changed an order on the CMS-485, and 78.3% rarely or never contacted SHHC clinicians with questions about information. The mean reported ease of contacting the SHHC agency was 4.7 (SD, 2.3) on a scale of 1 (easy) to 10 (difficult). Limitation: Self-reported data and 53% response rate. Conclusion: The CMS-485 does not meaningfully engage physicians. Physicians spend little time reviewing or acting on the SHHC plan of care. Strategies to enhance meaningful communication between SHHC agencies and physicians are needed.",
author = "Boyd, {Cynthia M.} and Bruce Leff and Julia Bellantoni and Navpreet Rana and Wolff, {Jennifer L.} and Roth, {David L.} and Kim Carl and Sheehan, {Orla C.}",
note = "Funding Information: Financial Support: Dr. Boyd was supported by the Paul Beeson Career Development Award Program: National Institute on Aging 1K23AG032910, the American Federation for Aging Research, the John A. Hartford Foundation, the Atlantic Philanthropies, the Starr Foundation, and an anonymous donor. Dr. Wolff was supported by National Institute of Mental Health grant K01MH082885. Dr. Rana was supported by the University of New England College of Osteopathic Medicine Peter Morgane Fellowship. The study was also supported by the Johns Hopkins Bayview Center for Innovative Medicine. Funding Information: Dr. Boyd was supported by the Paul Beeson Career Development Award Program: National Institute on Aging 1K23AG032910, the American Federation for Aging Research, the John A. Hartford Foundation, the Atlantic Philanthropies, the Starr Foundation, and an anonymous donor. Dr. Wolff was supported by National Institute of Mental Health grant K01MH082885. Dr. Rana was supported by the University of New England College of Osteopathic Medicine Peter Morgane Fellowship. The study was also supported by the Johns Hopkins Bayview Center for Innovative Medicine. Funding Information: Disclosures: Several members of the research team have been developing an informatics tool, based in part on the survey results reported in this article, to improve communication between their institution's nonprofit home health care agency and primary care physicians. This related work received funding from the National Institutes of Health. Dr. Boyd reports a grant from the National Institute on Aging Roybal Center outside the submitted work. Dr. Leff reports personal fees from Landmark Health and other support from Honor outside the submitted work and is a member of the Board of Directors of the Alliance for Home Health Quality and Innovation, the Board of Directors of the American Academy of Home Care Medicine, and the Editorial Board of Annals of Internal Medicine. Authors not named here have disclosed no conflicts of interest. Disclosures can also be viewed at www .acponline.org/authors/icmje/ConflictOfInterestForms.do?ms Num=M17-2219. Publisher Copyright: {\textcopyright} 2018 American College of Physicians.",
year = "2018",
month = may,
day = "15",
doi = "10.7326/M17-2219",
language = "English (US)",
volume = "168",
pages = "695--701",
journal = "Annals of internal medicine",
issn = "0003-4819",
publisher = "American College of Physicians",
number = "10",
}