Home Health Continues to Gain Steam Despite Projections of Down Admissions

Despite expectations that home health admissions in the U.S. would drop in Q3 2018, both home health admissions and utilization continued to increase slightly quarter-over-quarter. Meanwhile, Centers for Medicare & Medicaid Services (CMS) data shows hospice utilization rose to record-breaking levels in the third quarter of 2018, while hospice admission growth declined slightly. The findings […]

Letter to the Editor: Amedisys CEO Paul Kusserow Pushes Back on Improper Payment Reports

Your article, “CMS Made $3.2 Billion in Improper Home Health Payments in 2018,” deserves a headline that draws readers’ attention to the real story here. Only in the next-to-last sentence does the piece mention the most telling data point — namely, that improper home health payments “plummeted dramatically” between 2015 and 2018 from 59% of […]

Home Care Providers Look Ahead as Medicare Advantage Evolution Continues

Home care providers slow to chase Medicare Advantage business opportunities may now be motivated to speed up their pursuits. Last week, the Centers for Medicare & Medicaid Services (CMS) announced it was broadening the range of supplemental benefits Medicare Advantage (MA) plans can offer in 2020. Starting next year, health care policymakers will allow MA […]

CMS Finalizes In-Home Medicare Advantage Telehealth Policies

The Centers for Medicare & Medicaid Services (CMS) announced Friday that the agency has finalized a set of policies designed to expand the use of telehealth benefits under the Medicare Advantage program. Originally proposed in October 2018 for the 2020 plan year, the new policies from CMS are meant to expand access to telehealth services […]

Home Health Bankruptcies Likely to Rise After PDGM

Although a fairly common practice in the senior housing and skilled nursing worlds, home health providers as a group have largely avoided bankruptcy proceedings, partly thanks to a steady reimbursement landscape and increasing demand for services by older Americans hoping to age in place. If history serves as any guide, that’s likely to change under […]

CMS Picks Review Choice Demo Start Date, Releases New Details

The Centers for Medicare & Medicaid Services (CMS) has picked an official start date for its Review Choice Demonstration (RCD), an initiative meant to curb improper billing among home health providers. On Wednesday, CMS announced RCD will begin in Illinois on June 1. For home health providers operating in Illinois, that means all episodes of […]

CMS Adds More In-Home Care Services as Medicare Advantage Benefits for 2020

For the second year in a row, the Centers for Medicare and Medicaid Services (CMS) has widened the scope of supplemental benefits Medicare Advantage (MA) plans can offer, creating even more opportunities for home care providers to become partners in MA contracts. CMS is also giving the MA program a pay raise to help drive […]

CMS Launches AI Challenges for Predicting Unplanned Hospital, SNF Admissions 

The Centers for Medicare & Medicaid Services announced last week the launch of a three-stage challenge designed to encourage the use of artificial intelligence (AI) in health care. As part of the challenge, participants will be tasked with using AI to better predict unplanned hospital and skilled nursing facility admissions — already a key focus […]

CMS Made $3.2 Billion in Improper Home Health Payments in 2018

Despite increased oversight efforts, improper payments under Medicare and Medicaid are costing the federal government billions of dollars, a new report from the watchdog arm of Congress has found. And home health providers appear to be the root of the problem. In fiscal year 2018, improper Medicare fee-for-service (FFS) payments totaled $31.6 billion for all […]