NAHC’s Dombi: We’re Not Going To Be Bullied By Congress, CMS

There’s a flood of changes surging toward the U.S. home health care industry. But thanks to widespread recognition, improved quality and staunch advocacy efforts, providers have never been standing on higher ground. That was the key message delivered by the National Association for Home Care & Hospice (NAHC) leadership Sunday during the Washington, D.C.-based nonprofit […]

PDGM 101: Advice for Small-Scale Home Health Agencies

The Patient-Driven Groupings Model (PDGM) is less than three full months away. Among its biggest changes, PDGM halves the traditional 60-day billing period to 30 days and places greater emphasis on coding with a new 432-point case-mix mechanism. If those two changes weren’t enough, the overhaul also comes with a potential 8% behavioral adjustment cut […]

PDGM’s Lead Author Gets Candid About Pros, Cons of Revolutionary Model

Set to take effect on Jan. 1, the Patient-Driven Groupings Model (PDGM) is as controversial as it is revolutionary. The model’s therapy changes and behavioral assumptions are two reasons why. Home health operators worry their operations and patients will suffer as a result of those modifications, among others. Even PDGM’s lead author, Lisa Grabert, acknowledges […]

Bayada, Health Systems Back CMS’s Discharge Planning ‘Paradigm Shift’

In September, the Centers for Medicare & Medicaid Services (CMS) unveiled a new final rule regarding discharge planning requirements for hospitals and home health providers. The new rule, industry leaders say, will likely create a much needed paradigm shift in the discharge planning process. CMS’s discharge planning rule includes a number of changes that aim […]

New Trump Order Seeks Rate Equality Between Advantage Plans, Fee-for-Service Medicare

President Donald Trump signed a new executive order Thursday designed to bolster and expand Medicare Advantage (MA), the private Medicare insurance program for seniors that currently covers roughly 22 million individuals. While the executive order is relatively wide-ranging in scope, one major detail should immediately win the attention of home health providers. In the order, […]

CMS Pauses RCD in Two States Ahead of PDGM — But Moves Ahead in Texas

Good news for home health providers in North Carolina and Florida: The Centers for Medicare & Medicaid Services (CMS) will delay the implementation of Review Choice Demonstration (RCD) so agencies can adapt to the upcoming Patient-Driven Groupings Model (PDGM) first. Providers in Texas, however, won’t be as lucky. CMS announced Wednesday it is moving forward […]

Physician Education Likely to Pose Major Challenge Under PDGM

When it comes to the Patient-Driven Groupings Model (PDGM) and common concerns, most home health providers are quick to cite the overhaul’s widely opposed behavioral adjustments or controversial changes to therapy reimbursement. Although those two points are certainly important, PDGM also brings several lesser talked about, hidden challenges to the table as well. At the […]

LHC Group CEO: Biggest Innovation We Need Is Payment Innovation

When it comes to technology, there’s no shortage of gadgets and gizmos promising to innovate home-based care. In fact, during trade shows, all of the different technology being highlighted can sometimes feel a little like a scene from a science-fiction show. “I think we have seen the future of technology — we just haven’t started […]

CMS Announces New Hospital, Home Health Discharge Planning Requirements

The Centers for Medicare & Medicaid Services (CMS) released a final rule Thursday that makes changes to discharge planning requirements for home health providers. Broadly, the changes are part of CMS’s efforts to make patients a more active part of their care transitions out of the hospital and into other settings. “This delivers on President […]