NAHC’s Dombi: We’re Not Going To Be Bullied By Congress, CMS

There’s a flood of changes surging toward the U.S. home health care industry. But thanks to widespread recognition, improved quality and staunch advocacy efforts, providers have never been standing on higher ground. That was the key message delivered by the National Association for Home Care & Hospice (NAHC) leadership Sunday during the Washington, D.C.-based nonprofit […]

Private Equity Buyers Press Pause on Home Health Plans

In a change of pace compared to recent trends, private equity buyers appear to be shying away from home health purchases. There were at least 13 transactions for Medicare-certified home health assets in 2019’s third quarter, with many of those purchases coming from the industry’s big publicly traded companies, according to the latest quarterly M&A […]

Home Health Readmission Rates Remain Flat, Quality Improving

Despite providers often touting their success in keeping older adults at home and out of the hospital, average readmission rates for the home health industry remained relatively flat from 2017 to 2018. That’s according to the latest Home Health Chartbook, a comprehensive analysis of the post-acute care industry and home health sub-sector compiled by Avalere […]

PDGM 101: Advice for Small-Scale Home Health Agencies

The Patient-Driven Groupings Model (PDGM) is less than three full months away. Among its biggest changes, PDGM halves the traditional 60-day billing period to 30 days and places greater emphasis on coding with a new 432-point case-mix mechanism. If those two changes weren’t enough, the overhaul also comes with a potential 8% behavioral adjustment cut […]

Nexus Montgomery Launches SNF-to-Home Pilot to Improve Patient Transitions, Reduce Re-Hospitalizations

The steady march toward value-based care has encouraged providers across the continuum to get creative about patient care, especially when it comes to reducing avoidable hospital readmissions and improving the discharge process. One of the latest examples of an innovative cross-continuum partnership is spearheaded by Nexus Montgomery, a collaboration between six competing Maryland hospitals that […]

What ‘Significant’ AseraCare Ruling Means for Home Health Providers

A recent hospice-related court ruling may impact how federal watchdogs and whistleblowers go after home health agencies moving forward. Last month, the U.S. Court of Appeals for the Eleventh Circuit issued its long-anticipated decision in United States vs. AseraCare, a winding legal battle involving false claims allegations dating back to 2008. Hospice companies, other Medicare-reimbursed […]

New Trump Order Seeks Rate Equality Between Advantage Plans, Fee-for-Service Medicare

President Donald Trump signed a new executive order Thursday designed to bolster and expand Medicare Advantage (MA), the private Medicare insurance program for seniors that currently covers roughly 22 million individuals. While the executive order is relatively wide-ranging in scope, one major detail should immediately win the attention of home health providers. In the order, […]

Anthem Doubles Down on Home Care, Whole-Person Health for 2020

Anthem Inc. (NYSE: ANTM) and a number of its affiliated health plans were among the relatively few Medicare Advantage (MA) entities to actually offer home care-related supplemental benefits for the 2019 plan year. The Indianapolis-based Anthem was one of the first major insurers to publicly promote that fact as well, highlighting its expanded benefits packages […]

Elara Caring Names Alignment Healthcare Executive Scott Powers CEO

Elara Caring — the PE-backed home health, hospice and personal care giant created as the result of a three-way merger in 2018 — has a new top executive at the helm. The Addison, Texas-based company announced Friday that Medicare Advantage (MA) veteran Scott Powers is taking over as CEO, effective immediately. Powers replaces G. Scott […]

Physician Education Likely to Pose Major Challenge Under PDGM

When it comes to the Patient-Driven Groupings Model (PDGM) and common concerns, most home health providers are quick to cite the overhaul’s widely opposed behavioral adjustments or controversial changes to therapy reimbursement. Although those two points are certainly important, PDGM also brings several lesser talked about, hidden challenges to the table as well. At the […]