Review Choice Demonstration Clears Hurdle, Likely Starting Soon

The Review Choice Demonstration (RCD) is likely right around the corner for Illinois home health providers. The Centers for Medicare & Medicaid Services (CMS) announced March 4 it had received Paperwork Reduction Act approval for RCD from the White House Office of Management and Budget (OMB). Since OMB approval, the agency has been finalizing the […]

Primary Diagnosis Changes Among PDGM’s Most Overlooked Aspects

The Patient-Driven Groupings Model (PDGM) is just nine months from taking the home health care industry by storm. By now, operators should have started preparing for the sweeping adjustments on tap for 2020 — but taking the right steps at the right time is crucial to ensuring success.   Among its high-level changes, PDGM removes […]

How to Handle a Home Health Audit, According to a CMS Auditor

If you operate a home health agency, Laura Long and her colleagues are probably the last people you want to hear from. Long is the Medicare operations lead at AdvanceMed, one of five unified program integrity contractors (UPICs) nationwide hired by the Centers for Medicare & Medicaid Services (CMS) to audit and investigation home health […]

Home Health Providers Lag Behind Skilled Nursing Facilities in Preventing Re-Hospitalizations

While home health care is often touted as a cost-effective way to reduce readmissions, skilled nursing facilities (SNFs) — though more expensive — might be better at keeping patients out of the hospital post-discharge. That’s according to a new article published in JAMA Internal Medicine, which shows readmission rates for patients discharged to home health […]

Refinement Bills Are Chance to ‘Get PDGM Right,’ Avoid Industry Destablization

Joanne E. Cunningham took over as The Partnership for Quality Home Healthcare’s executive director in August 2018. Since then, much of her focus has been spent educating policymakers on the Patient-Driven Groupings Model (PDGM) and its potentially industry-shaping impact. So far, those advocacy returns have been promising, recently contributing to PDGM-refinement legislation in the U.S. […]

Trump Administration Looking to Cut Dialysis Costs with Home Focus

Hoping to curtail health care spending, the Trump administration is exploring ways to shift treatment for kidney disease into the home and away from dialysis clinics, a far costlier setting. Overall, the U.S. government spends roughly $114 million to treat chronic kidney disease and end-stage renal disease, according to a Monday report by Reuters. To […]

Paul Ryan: ‘Fee-For-Service Doesn’t work,’ MA the Future of Medicare

As if home care agencies needed any more encouragement to dive into the Medicare Advantage (MA) world, they got some last week — courtesy of a well-known Capitol Hill veteran. Home care providers have been positioning their businesses to appeal to potential MA players since April 2018, when Centers for Medicare & Medicaid Services (CMS) […]

Home Health Spending Rate Projected to Surpass All Other Care Categories

Roughly $108.8 billion is projected to be spent on home health care in the United States in 2019, according to a newly released analysis from the Centers for Medicare & Medicaid Services (CMS) Office of the Actuary. U.S. expenditures on home health care are projected to hit $186.8 billion by 2027. An aging population, a […]

LHC Group CEO Urges Congress to Support PDGM-Altering Bill

LHC Group (Nasdaq: LHCG) Chairman and CEO Keith Myers is again calling on Congress to pass legislation refining the assumption-based payment adjustments currently outlined under the Patient-Driven Groupings Model (PDGM). The co-founder of the Lafayette, Louisiana-based company recently penned an article in The Hill emploring legislators to pass S. 433, a new bipartisan bill that […]