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 […]
Category: CMS
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 […]
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 […]
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 […]
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 (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 […]
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 […]
The Medicare Payment Advisory Commission (MedPAC) paints a rosy portrait of home health margins. But an analysis of cost reporting data – that considers both traditional Medicare and Medicare Advantage (MA) payments – shows that providers are generally not sitting atop a hill of money. Instead, they are struggling to stay above water. Kalon Mitchell […]
Patients are receiving less access to Medicare-certified home health care in recent years, according to a new data analysis. The data analysis – which comes from the Partnership for Quality Home Healthcare (PQHH) and CareJourney by Arcadia – examines Medicare home health fee-for-service claims from 2022 through 2023, in order to determine access to care, […]
Yet another significant cut to home health payments has been proposed by the Centers for Medicare & Medicaid Services (CMS) for 2025. For providers, that means more pushback against cuts is in order, locally and in Washington, D.C. But it also means preparing for a world where Medicare fee-for-service is no longer a reliable backbone. […]
Subscribe
Receive industry updates and breaking news from HHCN