The Centers for Medicare & Medicaid Services (CMS) made waves in January when it unveiled plans to test a hospice carve-in under Medicare Advantage (MA), a step long viewed as “inevitable.” Specifically, CMS officials said they would test the feasibility of a hospice carve-in starting in 2021 through the MA Value-Based Insurance Design (VBID) model. […]
Category: Medicare Advantage
In an effort to expand its capabilities and open the door for future Medicare Advantage (MA) opportunities, Amedisys Inc. (Nasdaq: AMED) recently struck an agreement with ClearCare Inc. to create a network of personal care agencies. Already, that network is spreading like wildfire, with 308 agencies representing 32,000 caregivers in 39 states, Amedisys CEO and […]
The new Medicare Advantage opportunity for home care providers will break out in 2020 and boom in 2021. But while providers are already building the infrastructure and the partnerships necessary to capitalize on this enormous play, three major red flags remain. For Medicare Advantage (MA) to fully benefit from the power of home care, these […]
There has been a sharp rise in the number of Medicare Advantage (MA) enrollees over the past several years and a steady expansion of the program itself. But MA still isn’t the most reliable payment stream for post-acute providers, especially those who operate in the in-home care space, industry experts warn. In total, more than […]
Humana Inc. (NYSE: HUM) is seeing Medicare Advantage (MA) growth like never before, a point that contributed to its strong second quarter performance. The home-focused health insurance giant only expects membership to continue to boom in the months to come, executives predicted on a Q2 earnings call Wednesday. In Q2, Humana’s group MA membership was […]
The recent rule changes to Medicare Advantage (MA) from Centers for Medicare & Medicaid Services have created a level of flexibility and creativity for home care participation that is nearly unchecked. For example, the final call letter for MA plan year 2020 notes that “MA organizations have broad discretion” in determining what’s called the “Special […]
Humana (NYSE: HUM) is leaning even further into the home and its focus on social determinants of health, according to CEO Bruce Broussard. He hinted that the Louisville-based insurer could be placing even more importance on home- and community-based care in the years to come. “[With home-based care,] you have this holistic view of the […]
In a new report released Monday, the U.S. Department of Health and Human Services Office of Inspector General (OIG) highlighted dozens of its unimplemented recommendations for reducing fraud, waste and abuse throughout the Medicare and Medicaid systems. Many of the recommendations were tied to home health, hospice and personal care services, in addition to how […]
Medicare Advantage plans could get even more flexibility to address social determinants of health for beneficiaries if Health and Human Services Secretary Alex Azar has his way. In turn, that could mean even more opportunities for home care providers to offer and be reimbursed for services such as companion care, bathing, transportation and more. “Our […]
The Medicare Advantage revolution continues to grow — and starting in 2020, home care providers will reap the rewards. Through a series of law changes over the past decade, including the Patient Protection and Affordable Care Act of 2010 and the Bipartisan Budget Act of 2018, Medicare’s move away from fee-for-service models and toward value-based […]
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