Pennsylvania health insurer Independence Blue Cross (IBX) has partnered with post-acute benefit enablement company tango to expand access to home health care through value-based reimbursement arrangements. The partnership, announced on Tuesday, is designed to lower readmission rates and total cost of care by building IBX’s home health network for its Medicare Advantage members. “Our whole […]
Category: Medicare Advantage
One of my favorite parts of being HHCN’s associate editor is guiding our HHCN+ content – the stories and resources that our team invests the most time in and that feature some of the most expert voices in the home-based care industry. In this week’s HHCN+ Update, I’ll review the top stories and takeaways from […]
2025 was characterized by significant uncertainty across the home-based care landscape. Providers grappled with uncertainties surrounding the transition to a new presidential administration, potential changes to Medicare home health payment rates and the prospect of deep cuts to the federal Medicaid budget. As providers and advocacy groups worked to navigate a wave of consequential policy […]
Industry-wide pressures are necessitating that home-based care providers step away from traditional fee-for-service models – but payer trends and other factors can complicate the process of establishing innovative reimbursement arrangements. Some of the momentum toward value-based care in managed care has slowed due to pressure on payers, experts said during a recent Home Health Care […]
Referrals are home health providers’ “lifeblood” – but the referral landscape has become increasingly challenging, requiring providers to restrategize and differentiate themselves. To thrive in a rapidly evolving referral landscape, including the rise of Medicare Advantage and reimbursement pressures, providers are forced to accept different patient populations and find ways to stand out to potential […]
Elevance Health (NYSE: ELV) is continuing to expand its home-based service line – and seeing the benefits of doing so. Carelon, Elevance’s health care services arm, saw its Q3 operating revenue increase by $4.5 billion year-over-year, according to the company’s third quarter results. One driver of this growth is its acquisitions in home health services, […]
Despite increasing Medicare Advantage (MA) enrollment growth, the plans offering in-home support services decreased between 2024 and 2025. That was one key takeaway from a recent report from Better Medicare Alliance. The report, which offers an overview of MA, including demographics, enrollment, benefits, cost savings and outcomes, touted high rates of satisfaction and cost savings […]
The home-based care industry is plagued by regulatory, administrative and staffing challenges, among others. However, the most acute challenge facing providers, according to Luke Rutledge, president of Homecare Homebase, is the rapid rise of Medicare Advantage (MA). MA has become the primary payer source for home-based care services, according to Homecare Homebase data. To persist […]
Major health insurers have increasingly integrated care provider entities into their portfolios, including home-based care offerings – and are using their provider arms to inflate care prices and evade federal regulations. Payviders, which include the likes of UnitedHealth Group (NYSE: UNH), Elevance Health (NYSE: ELV) and CVS Health (NYSE: CVS), often utilize a loophole that […]
While financial assistance programs help some Medicare beneficiaries with premiums and cost-sharing, low- and near low-income individuals still face significant affordability challenges. Standard Medicaid benefits often entail significant cost-sharing, leading to high out-of-pocket (OOP) costs for beneficiaries. Medicare requires beneficiaries to pay deductibles and coinsurance for both inpatient and outpatient care, with no limit on […]
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