The looming Patient-Driven Groupings Model (PDGM), a potential hospice carve-in under Medicare Advantage (MA) and the expanding Review Choice Demonstration (RCD) are just a few of the developments reshaping the current landscape of home health and hospice. As if those three items aren’t enough, providers are also facing the continuing Value-Based Purchasing Model (VBPM), emerging […]
The Centers for Medicare & Medicaid Services (CMS) is moving forward with many of the provisions originally included in the Patient-Driven Groupings Model (PDGM) while also proposing to implement a new home infusion benefit, eliminate home health pre-payments and make Value-Based Purchasing Model (VBPM) performance data public. CMS detailed its plan for PDGM and other […]
A key ally for home health providers and a major proponent of value-based care may be leaving his federal post. The Trump administration revealed late Wednesday it has nominated Adam Boehler — director of the Center for Medicare & Medicaid Innovation (CMMI) and a senior adviser to the secretary of the U.S. Department of Health […]
Traditionally, home health services have often targeted older adults living in the broader community. Third-party management company LCS, however, has found a home health sweet spot within its vast network of continuing care retirement communities (CCRCs). Started in 1971 as a subsidiary of Des Moines, Iowa-based The Weitz Corporation, LCS provides broad-based services for the […]
The financial well-being of home- and community-based care providers often depends on Medicaid reimbursement, which has stagnated throughout much of the country in recent years. One state is trying to rebalance the equation with a first-of-its-kind annual inflation increase for all Medicaid home care and hospice direct fee-for-service rates. Last June, the Rhode Island General […]
The flood of home health support from Congress on the Patient-Driven Groupings Model (PDGM) front continues. On July 2, a bipartisan, bicameral group of lawmakers sent a letter to Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma, urging the agency’s leader to revisit certain widely opposed provisions of PDGM during CMS’s annual rulemaking […]
As the pages on the calendar continue to turn toward January 2020, the Patient-Driven Groupings Model (PDGM) remains a top priority for home health agencies big and small. But while the payment overhaul does mark the beginning of a new era in the industry, it can’t be providers’ sole focus. “It shouldn’t be: ‘PDGM is […]
A bipartisan group of U.S. lawmakers is looking to relax federal anti-kickback rules related to how, when and where physicians refer their patients. Doing so could mean smoother referral relationships for home health providers, especially the biggest ones and those operating within an accountable care organization (ACO). Efforts to loosen anti-kickback regulations come from the […]
Out-patient software provider Net Health announced Tuesday it has entered into an agreement to acquire Optima Healthcare Solutions, bringing the company firmly into the home health and hospice segments of the post-acute realm. Terms of the deal — expected to close later in July — were not disclosed. Led by Chairman and CEO Anthony Sanzo, […]
Encompass Health Corporation (NYSE: EHC) — the largest operator of in-patient rehabilitation facilities (IRFs) in the country, with a network of hundreds of home health and hospice locations to boot — has agreed to pay $48 million to resolve false claims allegations. The Birmingham, Alabama-based company had previously disclosed the matter in its public filings […]
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