Democratic Lawmakers Draw Attention To Dr. Oz’s ‘Deep Financial’ Ties To Medicare Advantage

Democratic lawmakers are expressing concern over President-elect Donald Trump’s choice of Dr. Mehmet Oz to head the U.S. Centers for Medicare and Medicaid Services (CMS). Specifically, lawmakers are focused on Oz’s advocacy for the elimination of traditional Medicare, and what they call his “deep financial ties” to private health insurers. In a recent letter — […]

Hidden Changes: What Home Health Providers May Have Missed In The Final Rule 

On Nov. 1, the Centers for Medicare & Medicaid Services (CMS) issued the final home health payment rule for 2025, updating Medicare policies and rates for home health agencies. But while the payment-related information grabbed headlines, there are plenty of other changes to home health care within the rule that providers should be paying attention […]

Medicaid ‘At Risk’ Under Incoming Administration, According To CMS Leader

The Medicaid program could face significant challenges under the Trump administration, according to Dan Tsai, the deputy administrator and director of the Center for Medicaid and Children’s Health Insurance Program (CHIP) Services. He expressed these concerns during a leadership update call from the Center for Medicare & Medicaid Services (CMS) on Wednesday. “Medicaid is so […]

CMS Home Health Admission-To-Service Policy Misses The Heart Of Providers’ Capacity Issues

With the 2025 home health final payment rule came the admission-to-service policy — an update to the Medicare Conditions of Participation. In many ways, experts consider it a formalization of measures home health providers are already taking. Broadly, the policy has two parts. The first part requires home health providers to develop, implement and maintain […]

Home-Based Care Provider HarmonyCares Thrives In ACO REACH’s First Performance Year

Formerly U.S. Medical Management, the home-based care company HarmonyCare raised $200 million in June. On Wednesday, it touted its success in the Accountable Care Organization (ACO) “REACH” Model, the successor to the The Global and Professional Direct Contracting Models (GPDC). Put forth by the Centers for Medicare & Medicaid Services (CMS), ACO REACH gives private […]

What The Election Result Means For Home-Based Care Providers

Donald Trump will take over the presidency again in January. There will be many implications for home-based care providers, and details from Trump’s first presidency will help project those. In the weeks leading up to the Nov. 5 election, Trump and Kamala Harris battled over home-based care. Specifically, Harris suggested a personal home care benefit […]

[Updated] CMS Finalizes 0.5% Home Health Payment Increase For 2025, More Permanent Cuts

The U.S. Centers for Medicare & Medicaid Services (CMS) released its CY 2025 home health final payment rule Friday. It comes with an estimated aggregate increase to 2025 home health payments of 0.5%, or $85 million, compared to 2024 aggregate payments. But another permanent cut will be implemented in the new year. “CMS estimates that […]

Medicare Advantage In-Home Health Assessments Continue To Raise Questions 

Medicare Advantage (MA) companies receive higher risk-adjusted payments from the Centers for Medicare & Medicaid Services (CMS) for sicker enrollees. This helps ensure that plans receive sufficient payments to cover increased care costs and that enrollees have access to plans. However, a new report states that taxpayers are footing the bill for billions of dollars […]

While Home Care Is Touted As A Panacea, Rates And Regulations Hold Providers Back

The U.S. health care system is banking on home- and community-based services (HCBS) to help keep seniors and individuals with disabilities at home and away from more costly brick-and-mortar facilities. But for now, incongruent rates mean disparate access to those services state by state. The Centers for Medicare & Medicaid Services (CMS) released the Medicaid […]