When the Centers for Medicare & Medicaid Services (CMS) first announced the Guiding an Improved Dementia Experience (GUIDE) Model in late July, there was excitement and an eagerness to learn more from home-based care providers. The goal of the model, according to CMS, is to “support people living with dementia and their unpaid caregivers.” Even […]
Category: CMS
Home health agencies aren’t reporting more than half of falls involving major injury or hospitalization on patient assessments for Medicare beneficiaries, a recent report from the Office of Inspector General (OIG) found. In order to compile this report, OIG looked for falls with major injury in Medicare hospital claims for home health patients, and then […]
The Centers for Medicare & Medicaid Services (CMS) first announced the Guiding an Improved Dementia Experience (GUIDE) Model in late July. Home-based care providers have now had time to think about the opportunity the model may bring with it. The goal of the model is to “support people living with dementia and their unpaid caregivers.” […]
The U.S. Centers for Medicare & Medicaid Services’ (CMS) home health proposed payment rule – which would slash rates by 2.2%, or an estimated $375 million less compared to 2023 levels – drew the ire of the industry’s heaviest hitters during the public comment period. The comments were critical of the proposed rule itself. They […]
The Centers for Medicare & Medicaid Services (CMS) unveiled a new state-focused demonstration model Tuesday. One of the model’s primary objectives is to shift health care spending and utilization more toward primary and community-based care. The States Advancing All-Payer Health Equity Approaches and Development Model (AHEAD Model) will aim to better address chronic disease, behavioral […]
Humana Inc. (NYSE: HUM) is suing the U.S. Department of Health and Human Services (HHS) due to its attempt to claw back billions of perceived overpayments from Medicare Advantage (MA) plans. The Centers for Medicare & Medicaid Services (CMS), which is a part of HHS, finalized a rule in January that would allow the agency […]
During the comment period for the 2024 home health proposed payment rule, the U.S. Centers for Medicare & Medicaid Services (CMS) received a host of responses from providers, industry advocates and other home-based care stakeholders. Chief among their concerns was the impact that the rule – if finalized in its current form – would have […]
The Medicare Shared Savings Program (MSSP) continues to save Medicare over a billion dollars annually. And some of the highest-performing, most innovative Accountable Care Organizations (ACOs) participating in the program continue to generate savings by effectively using home-based care. The U.S. Centers for Medicare & Medicaid Services (CMS) announced Thursday that MSSP saved Medicare $1.8 […]
Regardless of what the U.S. Centers for Medicare & Medicaid Services (CMS) decides to do with its home health final payment rule, industry experts believe providers need to drastically improve their cost reporting data. “CMS seems to think there are too many of us and we’re making too much money,” Robert Markette, an attorney with […]
Every year, industry stakeholders anticipate the U.S. Centers for Medicare & Medicaid Services’ (CMS) release of the home health proposed payment rule and the final rule. The final rule’s provisions and updates determine what the Medicare home health landscape will look like for the foreseeable future, but sometimes providers aren’t well-versed on the ins and […]
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