The latest ACO numbers from the Centers for Medicare & Medicaid Services (CMS) are in — and home health providers should be paying attention. More than two years ago, the Trump administration made major changes to the Medicare Shared Savings Program for accountable care organizations (ACOs), arguably the biggest value-based payment program in fee-for-service Medicare. […]
Category: Home Health Care
The 2019 fiscal year concluded with the Department of Justice (DOJ) bringing in $2.6 billion in recoveries involving health care fraud and false claims. Home health-related fraud was a large part of these efforts. This marks the 10th consecutive year that the department’s civil health care fraud settlements and judgments have exceeded $2 billion. The […]
We’re less than 10 days into the Patient-Driven Groupings Model (PDGM), but already some industry experts are hearing about the forthcoming shutdown of home health agencies. PDGM — the biggest home health reimbursement overhaul in two decades — began on Jan.1. “Right now, it’s really early to see some of these scenarios,” Mike Dordick, president […]
One method using in-home care that inspired hope in reducing health care spending may not be effective after all. Tending more to “super-utilizers” did not reduce hospital readmissions, according to a new study from The New England Journal of Medicine. Super-utilizers are the 5% of the patient population that make up half of the nation’s […]
Minneapolis-based North Memorial Health has partnered with Lifesprk, a holistic home care provider also based in Minneapolis, to help serve the health system’s rapidly aging patient population. And the partnership is already seeing some impressive results in terms of lowering re-hospitalization rates and ER utilization The goal of the partnership — announced in December — […]
Three years after Shelly Sun founded the Chicago-based BrightStar Care, she adopted a franchise model as a means for expansion, a somewhat unusual path for growing an in-home care company from scratch. BrightStar is now active in 39 states, able to reach 75% of the U.S. population within a 30-minute drive. Overall, the franchise network […]
For California’s older adult population, the aging-in-place floodgates are about to burst, as a series of aging-related bills take effect in January. In June, Gov. Gavin Newsom signed an executive order that called for the creation of a “master plan on aging.” The plan was meant to serve as a blueprint for state and local […]
U.S. health care spending soared past $3.6 trillion in 2018, nearly one-fifth of the country’s gross domestic product (GDP). To curb that spending, stakeholders throughout the continuum of care are beginning to think more about “total cost of care” and less about isolated episodes. Some of the largest in-home care providers are among those stakeholders, […]
In all likelihood, 2019 will go down as one of the most important years in Medicare-certified home health care history. While many industry-shaping changes didn’t officially begin last year, 2019 did set the stage for several new regulatory and business trends in 2020. Almost all of those trends are somehow linked to the Patient-Driven Groupings […]
The long-awaited Patient-Driven Groupings Model (PDGM) is finally here, marking the biggest home health reimbursement overhaul in two decades. PDGM officially launched on Jan. 1 after originally being proposed by the Centers for Medicare & Medicaid Services (CMS) in July 2018. With changes to billing periods, therapy reimbursement and LUPAs, it’s the most significant shift […]
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