Last week got off to a rough start for one of the biggest home-based care providers in the country. Bayada Home Health Care announced layoffs among 10% of its headquarters staff — this translates to about 100 jobs, focused on its operational and administrative support team. When a company as large as Bayada enacts layoffs, […]
UnitedHealth Group (NYSE: UNH) and Humana (NYSE: HUM) are pushing to increase oversight and limit payments to insurers for in-home clinical assessments in Medicare Advantage (MA). On Friday, UnitedHealth called to increase MA oversight of in-home clinical visits and deploy annual audits focused on in-home clinical visits. Humana told congressional staffers that it supported limiting […]
Home-based care is increasingly delivered under Medicare Advantage (MA) plans, often squeezing providers with thin margins. Despite MA’s growing market share, a “substantial” number of consumers are opting to switch back to traditional Medicare, according to new research. More than 35.7 million Americans are currently enrolled in MA plans. However, one in ten switch to […]
As Medicare Advantage (MA) continues its rapid rise, nonprofit home health care companies are grappling with unsustainable reimbursement rates, with some forced to walk away from specific care plans. Nonprofit home-based care providers are increasingly struggling to absorb the financial losses associated with Medicare Advantage (MA) plans, which now cover the majority of Medicare beneficiaries […]
The Centers for Medicare & Medicaid Services (CMS) announced that it is ramping up audits of all Medicare Advantage (MA) plans – which could possibly lead to decreased rates for home health providers. CMS’s plan to audit all eligible MA contracts each payment year and expedite audits for payment years 2018 to 2024, announced last […]
On Wednesday, a slew of bipartisan lawmakers reintroduced a bill that would overhaul the prior authorization process for seniors enrolled in Medicare Advantage (MA) plans and cutting through some of the red tape facing home health providers. The Improving Seniors’ Timely Access to Care Act would amend part of the Social Security Act and establish […]
A lawmaker introduced a bill to Congress requiring Medicare Advantage (MA) plans to pay for hospice care, creating potential fallout for home health providers that offer hospice services. Mollie Gurian, vice president of policy and government affairs at LeadingAge, an association of nonprofit providers of aging services, called the bill, H.R. 3467, “very ill-conceived.” “Not […]
As Medicare Advantage (MA) enrollment continues to surge, home health providers have seen slim margins deteriorate further. Some providers have openly expressed their decision to reject financially unsustainable MA contracts. Abandoning unfavorable MA contracts may sometimes be necessary, industry executives told Home Health Care News. However, some providers have improved their MA standing by renegotiating […]
The Department of Justice’s (DOJ) health care fraud unit is investigating UnitedHealth Group (NYSE: UNH) for criminal Medicare fraud, according to a report from the Wall Street Journal (WSJ). The exact details of the criminal allegations against UnitedHealth Group were not clear, according to the article, but the federal investigation is said to relate to […]
Leading home-based care providers announced new partnerships and strategic expansions this month in an effort to efficiently and cost-effectively provide care for the growing aging population in the U.S. HomeCentris Healthcare acquires Family First Healthcare HomeCentris Healthcare has acquired Family First Home Healthcare. The deal closed on April 3, and HomeCentris has begun integrating the […]
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