Game On: PDGM Encourages Home Health Agencies to ‘Game the System’

When the Center for Medicare & Medicaid Services (CMS) developed the Patient-Driven Groupings Model (PDGM), part of the goal was to fix problems that exist with the currently used Prospective Payment System (PPS). One such problem, government watchdogs say, is agencies prioritizing quantity of care over quality because it often leads to more money. Thus, […]

CMS Finding New Ways to Penalize Home Health Providers

The Centers for Medicare & Medicaid Services (CMS) is finding new ways to penalize home health providers. In its proposed payment rule for 2020 released last week, CMS floated the idea of phasing out pre-payments for home health services starting in 2020, killing them completely by the following year. Currently, home health providers can receive […]

NAHC’s Dombi: CMS Needs to ‘Back Off’ RAP Proposal, PDGM Assumptions

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 […]

[Updated] CMS Proposes Elimination of RAPs, $250 Million Medicare Payment Increase

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 […]

Home-Based Care Ally Adam Boehler to Leave CMMI

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 […]

Cisco, American Well Developing Telemedicine-Enabled TV for Seniors 

Multinational technology powerhouse Cisco Systems Inc. (Nasdaq: CSCO) and privately held telemedicine company American Well are joining forces to turn consumers’ television sets into virtual doctor’s offices. Unlike telemedicine services that depend on tablets and similar mobile platforms, San Jose, California-based Cisco is reportedly in the early stages of creating a device meant to be […]

MedPAC Questions Home Health Providers’ Reporting on Patient Functional Ability

For years, the Medicare Payment Advisory Commission (MedPAC) has floated the idea of a unified payment system for all post-acute care providers — skilled nursing facilities (SNFs), in-patient rehabilitation facilities (IRFs), long-term care hospitals (LTCHs) and home health agencies. MedPAC and its team of 17 commissioners provided additional insight into what a potential unified model […]

Payment Overhauls to Bring SNFs, Home Health Providers Closer Together

Similar to home health providers facing the Patient-Driven Groupings Model (PDGM), skilled nursing facility (SNF) operators are months away from a major payment overhaul themselves. Effective beginning Oct. 1, the Patient-Driven Payment Model (PDPM) should trigger more collaboration between the SNF and home health worlds — at least in theory. Understandably, the two complex models […]

CMS: No ‘Secret List’ of Troubled Home Health Agencies

Earlier this week, a bipartisan pair of U.S. senators released a “secret list” of nursing homes under consideration for placement on the federal government’s roster of properties with serious quality issues. Maintained by the Centers for Medicare & Medicaid Services (CMS), the list features more than 400 nursing homes that are “candidates” for the Special […]