Exploring Managed Medicaid Challenges In Home-Based Care

Home-based care providers working with Medicaid managed care plans have to navigate an operating environment that is more administratively complex. That’s one of the key takeaways from a recent webinar hosted by the National Association for Home Care & Hospice (NAHC). Since 2020, states like North Carolina, Oklahoma and Idaho have implemented managed care programs. […]

How Home Care Providers Establish Credibility With Managed Medicaid Plans

Home-based care providers — both big and small — are struggling at the negotiating table with Medicare Advantage (MA) plans. But they’re also struggling in negotiations with managed Medicaid plans. While MA plans and managed Medicaid plans operate a bit differently, providers are having similar issues with both. Proving value to health plan leaders is […]

Addus CEO Slams CMS Medicaid Proposal: You’re Going To See A Vast Majority Of The Small Mom And Pops Go Out Of Business

Of all the challenges home-based care providers are facing, it’s the U.S. Centers for Medicare & Medicaid Services’ (CMS) proposed rule regarding Medicaid access that is top of mind for Addus HomeCare Corporation (Nasdaq: ADUS) leaders. Addus Chairman and CEO Dirk Allison called CMS’s proposal the company’s “biggest challenge” over the past several weeks. “They’re […]

Home Care Groups: Industry Needs More Time To Review ‘One Of The Most Impactful Proposed Rules’ In Medicaid HCBS History

Three major home-based care groups are asking the U.S. Centers for Medicare & Medicaid Services (CMS) for more time to review the agency’s recent Medicaid proposal, which features a handful of provisions that could prove challenging for operators. Among those provisions mandate thresholds on reimbursement, in which CMS would require that at least 80% of […]

Medicaid Wage Proposal Could Prompt HCBS Operators To Exit Market, Discourage New Providers From Entering

The U.S. Centers for Medicare & Medicaid Services (CMS) recently published two proposed rules that have major implications for home-based care providers. The provision that has created the greatest waves among providers and industry stakeholders is the potential requirement that at least 80% of Medicaid payments for personal care, homemaker and home health aide services […]

Why Certain States Spend Big On Medicaid HCBS

According to the most recent data, an estimated 5.8 million people utilize home- and community-based long-term services and supports (LTSS). Medicaid is the primary payer for LTSS. The U.S. spent over $400 billion on LTSS in 2020, nearly 10% of all health care expenditures. More than half of that spending went toward home- and community-based […]

The Unintended Consequences Of CMS’ Proposed HCBS Medicaid Rule

The U.S. Centers for Medicare & Medicaid Services (CMS) recent proposed rule for Medicaid may cap business for certain providers, but industry experts believe the government agency is likely foreshadowing its intentions for the final rule. The new rule would force 80% of payment to go to workers in home- and community-based services (HCBS). There […]

Modivcare Continues To Grow Personal Care Segment, Unconcerned With Medicaid Rule Proposal

Despite some concern from industry peers, Modivcare Inc. (Nasdaq: MODV) isn’t sweating the U.S. Centers for Medicare & Medicaid Services’ (CMS) latest proposed rule, which includes a provision that would require at least 80% of Medicaid payments to go toward compensation for personal care workers. There are a couple of reasons for this, according to […]