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Who Can Help Me?

What Is The Home Care


So
Alliance of Massachusetts?
While the Alliance does not have the
resources to assist new home care business
in start-up, a number of consultants and
The Alliance is a statewide trade association You Want To Start
companies do. The following are members
dedicated to promoting home care as an
integral part of the healthcare system. With A Home Care Agency?
of the Alliance and have extensive more than 180 member agencies, the
experience: Alliance is the definitive voice for home- Home care is one of the fastest-growing
based care in Massachusetts. The Alliance segments of the health & human services
Jo Anne Aramini also: industries. Owning a home care agency can
(508) 366-2801 provide you with a meaningful and profitable
joannearamini@gmail.com Advocates for appropriate state and career where you can be your own boss,
federal regulations (and helps members make your own decisions, and decide your
Valerie Donnelly understand and comply with them); own future.
(617) 786-1431
valeriedonnelly@yahoo.com Provides educational programs to keep
its members on top of regulatory
Joan Usher changes;
JLU Health Record Systems
(781) 829-9632 Offers group purchase programs to give
jluhealth@verizon.net member agencies access to the best
supporting services at the best prices;
Cheryl Pacella Facilitates networking to help member
(617) 756-1442 agencies succeed and collaborate;
capacella27@gmail.com
Publishes a weekly newsletter. Offers
referral services through its annual
Any arrangements you make with any of directories and on its website,
these consultants are strictly between you www.thinkhomecare.org.
and the consultant; the Alliance receives no
financial incentive for listing these them. A successful homecare agency requires a
This list is for informational purposes only careful business plan that considers start-up
and is not intended to be an endorsement of costs, local demand and competition,
these consultants. workforce recruitment, and marketing. And
like all new businesses, new home care
agencies have a high failure rate during their
first few years.

This brochure will answer your basic


questions, help you think through the
necessary steps, and provide you with links
and references to additional information
sources.
Where Do I start? What Regulatory Issues Affect MassHealth provider is available at
www.mass.gov/eohhs/gov/departments/
First, decide which kind of client youre Private Care? masshealth.
seeking: those who can pay for care Mass DPH requires that all agencies placing
privately (i.e., out of pocket), or those who workers in the home conduct a criminal Other insurers including health plans and
rely on third party payers such as insurance background check (called a CORI) of the long term care insurers have their own
agencies, or Medicare and Medicaid. The worker upon hire. The state MA Criminal authorization and billing requirements (For
answer depends on a variety of factors History Systems Board administers the private pay services, rates and billing
including your local demographics, CORI system at www.mass.gov/eopss/crime procedures are between the agency and
competition, and expertise. One popular -prev-personal-sfty/bkgd-check/cori. client).
strategy is to focus on privately-paid care
initially, and to expand to third-party DPH also enforces regulations regarding
payment once the business is established. patient abuse prevention, reporting, and
How Do I Get Patients?
investigation, including a Nurse Aide Massachusetts is a competitive market for
What If I Want to Bill Insurers, Registry that agencies must access to home care. There are more than 100
screen all staff. Information about the Medicare certified agencies, and at least
Such As Medicare? registry is at www.mass.gov/eohhs/gov/ 200 private care agencies serving the
Most insurers require an agency to be departments/dph/programs/hcq/nurse-aides. states 356 cities and towns. Strategies for
Medicare certified and comply with the attracting clients include traditional
Medicare Conditions of Participation. advertising, outreach to local community
These standards are established by the
How Do I Get Paid? groups, physicians and hospitals. Because
federal Centers for Medicare and Medicaid Agencies that are not Medicare certified can the marketplace is competitive, agencies
Services (CMS). Information is available at provide and bill for homemaker and home must be able to deliver a quality product at a
www.cms.hhs.gov/center/hha.asp. care aide services through the state-funded competitive rate.
home care programs administered by the
In Massachusetts, the certification process state Executive Office of Elder Affairs The Home Care Alliance also has online
is handled by the Department of Public (EOEA). Rules on this program are available and print directories of its member agencies.
Health (DPH), Division of Health Care at www.mass.gov/elders. Visit us online at www.thinkhomecare.org/
Quality. Mass DPH can be reached at (617) join to learn more about the benefits of
753-8000) or www.mass.gov/dph/dhcq and The EOEA enrollment process called the membership with the Alliance.
provides prospective agencies with a Homemaker Notification of Intent to Contract
package of information on certification. is available on the EOEA website at
www.800ageinfo.com. Authorization and
The certification process can take as little as payment for the EOEA program is handled
several months, though it can also take as by EOEAs regional subcontractors, called
much as a year to complete. Aging Service Access Points.

Note: A+ certification survey can not be Certified agencies can directly bill Medicare
scheduled until a start-up agency has a and Medicaid for services that meet
record of caring for at least ten patients. program coverage requirements. Medicare
bills for agencies in Massachusetts are
processed by National Government
Services at www.ngsservices.com.
Information about enrolling as a Medicaid