Training deserves a place in the care plan

What we found in the news

On November 2, 2023, CMS announced the 2024 Medicare Physician Fee Schedule final rule (opens in a new tab), including payment for certain caregiver training services. The policy concerned training delivered by specified health professionals to help carry out a person's treatment plan. CMS placed the training:

“as part of the patient’s individualized treatment plan”

— Centers for Medicare & Medicaid Services, November 2023

The changes were for 2024, beginning January 1. This was payment to practitioners for qualifying services, not a wage or general payment to family caregivers. A general class or helpful conversation would not automatically qualify. The announcement invites a useful discussion about making learning a deliberate part of care.

Why this matters to us

Receiving instructions and feeling ready to use them are different experiences.

Imagine an illustrative planning conversation involving a person receiving care, a family supporter, and a clinician. The family member has been given several resources, but still has a question about helping with an agreed everyday routine. The person receiving support has a preference that the instructions do not mention.

There is an opportunity to slow down, hear both contributions, and decide what teaching would be useful. At genus, we are interested in how knowledge becomes something people can use together. A learning opportunity should help people understand their choices and responsibilities, including the limits of what they feel able to do.

Begin with the task and the people involved

Ask what the person receiving care wants support with, who they would like involved, and what is already working. Then invite the caregiver to describe the part they find unclear or difficult.

A team may discover that the immediate need is a clearer explanation, a different format, or another conversation with the appropriate professional. More material is not always the answer. The person may also prefer a different arrangement from the one others had assumed.

Agree a manageable purpose for the session. Explain which questions the professional can address and what needs another assessment. This avoids turning an ordinary teaching conversation into an expectation that a family member will take on every task.

Leave time to try, pause, and ask again

Where practice is appropriate, a qualified professional can decide what to demonstrate and how to check understanding safely. The person and caregiver should have room to describe what feels unfamiliar, ask for a different explanation, or say that the proposed arrangement will not work at home.

Keep the actual setting in mind. A demonstration in a quiet clinic may need discussion about the space, equipment, communication preferences, and support available elsewhere. Those details belong in the professional's assessment, rather than being left for a family to improvise.

A question asked halfway through may change the plan. Make that contribution welcome. A completed session should not be treated as proof that someone is ready, willing, or available to provide ongoing help.

Give learning somewhere to go after the session

Before the conversation ends, agree what the person and caregiver can refer to later and who can answer a follow-up question. Select material that matches the professional's instructions, and make its purpose clear.

In our example, a short reviewed reminder might be more useful than a folder of general information. Check whether the intended reader can open it, understand it, and find the relevant part. Offer another format when that would help.

For organizations planning services around the payment change, qualified clinical and billing teams need to confirm the applicable requirements. Keep that work connected to service planning without asking the family to resolve coding questions. The illustration here describes a learning approach; it does not establish that a particular session is billable.

What this means for the people you serve

Caregivers can contribute experience, ask for teaching, and explain the boundaries of their role. People receiving care should help shape what is taught and how assistance is offered. Better preparation should create room for a considered agreement, including a different plan when the expected support is not workable.

The genus connection

Today, genus content and pathways tools support prepared resources such as text, media, documents, and questions. Selected resources can be arranged in a sequence and delivered through the configured experience, with human review and appropriate permissions.

Those capabilities can give an organization a place to prepare and revisit approved learning material. The clinician still decides what is suitable for the person, and the organization must confirm its service and payment requirements. A resource viewed or a question answered is not, by itself, evidence of clinical competence, consent, or a reimbursable training service.

One question for your next service-planning meeting

Where does our care plan leave time for someone to learn, ask again, and tell us what they cannot reasonably take on?