Amedisys Weary of Current Medicare Advantage Opportunities, Bullish on SNF-to-Home Diversion

Just as the Patient-Driven Groupings Model (PDGM) was slowly becoming the new normal, home health providers were hit with the impact of the COVID-19 emergency. Amedisys Inc. (Nasdaq: AMED) has weathered both storms. Now, it has its sights set on gaining market share from skilled nursing facilities (SNFs) and pursuing Medicare Advantage opportunities — but […]

Market Forecast: COVID-19’s Long-Term Impact on Home Care

The home care industry has historically been built on nonmedical services and a private-pay revenue structure. It has also long been underappreciated by the health care sector at large. But all of that’s changing. Nonmedical home care providers have proven their worth and range amid the COVID-19 crisis, keeping high-acuity seniors safe at home while […]

Rural Markets May Offer Huge Upside for Home Care Providers Looking to Break into Medicare Advantage

Many home care providers jumped at the chance to create new Medicare Advantage (MA) business lines after the U.S. Centers for Medicare & Medicaid Services (CMS) began making supplemental benefits more flexible more than two years ago. Now, those same providers that got into MA early are beginning to better understand the space while hunting […]

Family Resource Home Care CEO: Providers Must ‘Hold the Line’ When Negotiating with MA Plans

While some ground has been gained, home care’s campaign into Medicare Advantage (MA) territory has sometimes felt like an inch-by-inch progression rather than a full-on assault. But that shouldn’t be too surprising for those familiar with how MA plans think, according to Jeff Wiberg, the CEO of Family Resource Home Care, a large home care […]

COVID-19 Prompts Payers to Show ‘Real Appreciation’ of Home-Based Care

Like every other provider in the home-based care industry, Addus HomeCare Corporation (Nasdaq: ADUS) has spent the past three months grappling with the coronavirus. In the short term, that has meant decreased visit volumes and reduced revenues. But in the long-term, Frisco, Texas-based Addus is optimistic the COVID-19 emergency will usher in a number of […]

New CMS Medicare Advantage Rule Creates Incentives for Providers to Invest in Telehealth

The Centers for Medicare & Medicaid Services (CMS) announced Friday it has finalized changes to Medicare Advantage (MA) and Medicare Part D. The changes — detailed in a final rule for 2021 — partly seek to strengthen access to telehealth services, an increasingly important component of the health care system amid the ongoing coronavirus emergency. […]

To Tackle New Senior Care Challenges, MA Plans Lean Further into Social Determinants of Health

For years now, home care providers have drooled at the thought of contracting with Medicare Advantage (MA) plans. Now amid the coronavirus, agencies could have the chance to accelerate their MA strategies. Seniors are being forced to become more isolated than ever to mitigate their risk of catching the COVID-19 virus. In turn, MA plans […]

‘Rare Flexibility’ for Medicare Advantage Plans Could Lead to Home Care Inflection Point

The Centers for Medicare & Medicaid Services (CMS) has granted further flexibility to Medicare Advantage (MA) plans to offer more benefits to beneficiaries during the COVID-19 crisis. For home care providers, that could mean more business opportunity. The Special Supplemental Benefits for the Chronically Ill (SSBCI) program was announced in 2019 for the 2020 plan […]