The Comprehensive Care for Joint Replacement (CJR) model has had a modestly positive effect on how often joint replacement patients receive home health care, but “sizeable portions” of these patients still “miss out” on such services. This is according to study findings recently published in the American Journal of Managed Care. To enhance care coordination […]
Category: CMS
The Trump administration has instructed federal health agencies to pause all external communications, including health advisories, weekly scientific reports, updates to websites and social media posts, according to reports by CNN and the Washington Post. These orders were conveyed on Jan. 21 to staff at agencies within the U.S. Department of Health and Human Services […]
The U.S. Centers for Medicare & Medicaid Services (CMS) has laid out an action items timeline for the transition to all-payer Outcome and Assessment Information Set (OASIS) data collection and submission. The all-payer OASIS data requirement is set to begin in 2027. Broadly, home health providers will be required to collect and submit OASIS data […]
In response to hospital capacity challenges brought on by the COVID-19 pandemic, the Centers for Medicare & Medicaid Services (CMS) collaborated with external experts to create the Acute Hospital Care at Home (AHCAH) initiative. This initiative will expire on Dec. 31 unless Congress extends it. After three years of implementation, early insights regarding quality, costs […]
Democratic lawmakers are expressing concern over President-elect Donald Trump’s choice of Dr. Mehmet Oz to head the U.S. Centers for Medicare and Medicaid Services (CMS). Specifically, lawmakers are focused on Oz’s advocacy for the elimination of traditional Medicare, and what they call his “deep financial ties” to private health insurers. In a recent letter — […]
On Nov. 1, the Centers for Medicare & Medicaid Services (CMS) issued the final home health payment rule for 2025, updating Medicare policies and rates for home health agencies. But while the payment-related information grabbed headlines, there are plenty of other changes to home health care within the rule that providers should be paying attention […]
With the passage of the most recent home health final rule, providers are reminded that clawbacks are still hanging over their heads. Broadly, temporary cuts, or clawbacks, are an attempt from the U.S. Centers for Medicare & Medicaid Services (CMS) to recover perceived overpayments from home health providers in relation to the shift to PDGM. […]
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 […]
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 […]
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