In the first year that truly felt “post-COVID,” home-based care providers did not see a shortage of challenges. Instead, in 2023, home health providers saw another year defined by payment struggles, with both the Centers for Medicare & Medicaid Services (CMS) and Medicare Advantage (MA) plans. Home care providers, meanwhile, were still grappling with high […]
Category: Medicare Advantage
Home health providers have griped with their Medicare Advantage (MA) plan partners for years over poor rates, claim denials and increased administrative burden. Providers have stopped short of banding together to deny coverage for these plans, but some of the top companies have reallocated capacity to “preferred payers.” In the end, though, it may not […]
A class-action lawsuit was filed against Humana Inc. (NYSE: HUM) in Kentucky on Tuesday. The company is the latest insurer under fire over its alleged utilization of AI to dictate or deny post-acute care. Humana Medicare Advantage (MA) beneficiaries, specifically, filed the lawsuit, alleging that the company illegally used algorithms to limit post-acute care services. […]
CVS Health (NYSE: CVS) held its investor day Tuesday, which included company leaders’ ambitious plan for the future. That plan includes a synchronization of its health care delivery arm with the rest of the enterprise, and that health care delivery arm, of course, includes home-based health care. “We said we wanted to be in primary […]
Humana Inc. (NYSE: HUM) has formed a partnership with CINQCARE, a health care company that delivers care in the home and community. “At Humana, our unwavering commitment has always been to provide high-quality care and improve health outcomes,” Julie Mascari, president of Humana Northeast regional Medicare, said in a press statement. “By combining our expertise […]
UnitedHealth Group (NYSE: UNH) had its annual investor day Wednesday. While the event has included much about home-based care in the past, this time, home health care gained an even brighter spotlight with LHC Group President and CEO Josh Proffitt presenting. Company leaders spent the day tying home-based care to all sorts of initiatives: to […]
Home health providers’ battle for fair reimbursement from Medicare Advantage (MA) plans will be a “generational battle,” and not one they will win overnight. But, at least for larger home health providers, their strategies in that battle are much more definitive than they were even a few years ago. Luke James, the president of VitalCaring, […]
Over the years, Humana Inc. (NYSE: HUM) has been vocal about prioritizing value-based care. On Wednesday, it released its annual “Value-Based Care Report,” which affirms why its been crucial to the company’s Medicare Advantage (MA) beneficiaries. Overall, MA members who are getting care through value-based arrangements received more time with their primary care physician. These […]
Traditional Medicare beneficiaries are finding they have solid access to home health care. Medicare Advantage (MA) members utilizing home health care, on the other hand, are having a much harder time accessing care. That’s according to data in the newly released 2023 Home Care Chartbook from the Research Institute for Home Care (RIHC). The RIHC […]
To thrive and survive in a value-based care world, post-acute care providers need to be able to partner – and pivot – on the fly. Convincing payers of their worth is undoubtedly the first step, however. Quality home-based care providers have significant worth, they just need to be able to show it. But where providers […]
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