Small and mid-sized home health providers likely face an uphill battle in 2020, thanks largely to the cuts included in the Patient-Driven Groupings Model (PDGM) and policymakers’ plans phase out pre-payments. So far, multiple industry prognosticators are predicting that 30% or more of home health providers will close up shop next year, with rural agencies […]
When it comes to the Patient-Driven Groupings Model (PDGM) and the impact the overhaul will have on the home health industry in 2020, outlook largely varies depending on who you talk to. On one hand, some industry insiders have told Home Health Care News that PDGM — mandated to be budget neutral by Congress — […]
The Review Choice Demonstration (RCD) is expanding. The Centers for Medicare & Medicaid Services (CMS) announced Monday that home health providers in Ohio will be next in line for RCD, a revived version of the failed Pre-Claim Review Demonstration (PCRD) meant to combat improper billing. Home health providers in Illinois — the only state with […]
Encompass Health Corp. (NYSE: EHC) has lowered internal estimates on how the Patient-Driven Groupings Model (PDGM) will impact its home health operations, though the company remains firmly against assumption-based behavioral adjustments included in the payment overhaul. CEO Mark Tarr — along with home health and hospice segment leader April Anthony as well as other execs […]
With just five full months to go before the Patient-Driven Groupings Model (PDGM) becomes a reality, home health providers have reached crunch time. As it has been all along, the assumption-based behavioral adjustment baked into PDGM remains the home health industry’s No. 1 issue. Orginally, the behavioral adjustment was estimated to create a 6.42% payment […]
In a new report released Monday, the U.S. Department of Health and Human Services Office of Inspector General (OIG) highlighted dozens of its unimplemented recommendations for reducing fraud, waste and abuse throughout the Medicare and Medicaid systems. Many of the recommendations were tied to home health, hospice and personal care services, in addition to how […]
After federal health care policymakers fine-tuned the Patient-Driven Groupings Model (PDGM) last October with a 6.42% cut based on certain behavioral assumptions, some industry experts predicted there would be a modest uptick in home health bankruptcies in 2020. “The last time the industry went through this kind of major change was in the late 1990s […]
As part of its Patients Over Paperwork initiative and as a way to make home health requirements more consistent with other settings of care, the Centers for Medicare & Medicaid Services (CMS) is proposing to allow therapist assistants to furnish maintenance therapy. Under current home health rules, only physical therapists (PTs), occupational therapists (OTs) and […]
Home health providers continue to see a rise in patients coming from the community instead of hospitals and other institutional settings, recently released Medicare data shows. From 2001 to 2017, the number of home health episodes not preceded by a hospitalization or other post-acute care (PAC) stay increased by nearly 124%, according to updated figures […]
Humana Appoints Segment President Louisville, Kentucky-based Insurance giant Humana Inc. (NYSE: HUM) has named the next leader of its ever-evolving home business segment. Susan Diamond will serve as segment president of Humana’s home business segment moving forward, according to the company. The segment was previously led by William Fleming, who will continue to lead Humana’s […]