CMS Updates ACO REACH As Program Enters ‘Pivotal Phase’ 

The Centers for Medicare & Medicaid Services (CMS) recently announced updates to the Accountable Care Organization (ACO) “REACH” Model, which provides private home-focused health care providers with an opportunity to participate in risk-sharing agreements with traditional Medicare. The new updates are essentially “tweaks” based on learnings acquired through the first two years of the program’s […]

UnitedHealth, Humana Advocate For Limits On Medicare Advantage Home Visits

UnitedHealth Group (NYSE: UNH) and Humana (NYSE: HUM) are pushing to increase oversight and limit payments to insurers for in-home clinical assessments in Medicare Advantage (MA). On Friday, UnitedHealth called to increase MA oversight of in-home clinical visits and deploy annual audits focused on in-home clinical visits. Humana told congressional staffers that it supported limiting […]

Why CMS’ GUIDE Model Could Move Home Care From Side Act To Main Stage

The Guiding an Improved Dementia Experience (GUIDE) Model might be one of the biggest steps in the right direction for recent Medicare policy. The eight-year voluntary nationwide program was launched last year by the Centers for Medicare & Medicaid Services (CMS), with the goal of supporting individuals living with dementia, as well as their unpaid […]

Comfort Keepers CEO Seeks ‘Full Coverage Nationally’ Through Strategic Market Expansion

Six months after telling Home Health Care News that balancing quality care with Medicaid’s limited reimbursement rates was among her top challenges, Comfort Keepers CEO Natalie Black is closely watching potential updates to Medicaid policy. The executive is monitoring the Medicaid situation while pursuing two major aims: completing the company’s transition to a fully franchised […]

House Passes Budget Bill, Sparking ‘Ugly Consequences’ Warnings From Home-Based Care Advocates

The House of Representatives passed a budget bill on Tuesday that, if passed, would create a challenging rate environment and additional administrative burden, among other dangers, for home-based care providers. The bill includes an estimated $698 billion budget cut to federal Medicaid subsidies over a decade and an estimated $45 billion cut to Medicare spending […]

Lawmaker Introduces Bill To Protect Programs Critical To Home-Based Care

A newly introduced bill would aim to limit fallout from staffing cuts and regional office closures instituted by Elon Musk’s “Department of Government Efficiency” (DOGE), some of which have concerned the home-based care community. The Protecting Retirement and Health Benefits for Families Act, introduced by Rep. Mikie Sherrill (D-New Jersey), if passed, would protect retirement […]

‘Stay Tuned’: New CMS Innovation Strategy Centers At-Home Care, Raises Concerns Over Increased Provider Risks

The Center for Medicare and Medicaid Innovation (CMMI) announced its new strategy in response to United States Secretary of Health and Human Services Robert F. Kennedy Jr.’s call to “Make America Healthy Again” on Tuesday. The announcement was light on details but appears favorable in terms of prioritizing more at-home care. However, federal officials also […]

CMMI Announces Make America Healthy Again Strategy, Prioritizes Choice For Care Settings, Including In Homes

The Center for Medicare and Medicaid Innovation (CMMI) announced its approach to President Donald Trump and Secretary Robert F. Kennedy’s call to “Make America Healthy Again” – and it promises to, among other aims, increase patients’ ability to receive care in the setting of their choice, including the home.  The new strategy, announced Tuesday, also […]

Home-Based Providers Report Early Success With GUIDE Model

In what has been considered the most significant shift in recent Medicare policy, the Centers for Medicare & Medicaid Services (CMS) launched the Guiding an Improved Dementia Experience (GUIDE) Model last year. Home-based care companies are enthusiastically embracing the GUIDE Model, often teaming up with vendors to do so. Care providers already report benefits, including […]

Trump Administration Proposes $674M Cut To CMS Budget, Alarming Home-Based Care Advocates

With providers on edge regarding massive cuts to Medicaid and other health care programs, the White House officially released its budget proposal on Friday, which includes a $674 million reduction in funding for the Centers for Medicare and Medicaid Services (CMS), which controls government health insurance programs critical to the home-based care community. While the […]