OIG Targets Home Health Improper Payments, EVV, Consumer-Directed Programs in Ongoing Watchdog Initiatives 

In past years, Medicare-certified home health agencies and Medicaid personal care services providers have been big focus areas for government watchdogs. While there’s still plenty of oversight, the spotlight on home health and personal care providers appears to have dimmed somewhat. Instead of focusing on home health and personal care, watchdogs are increasingly targeting hospices, […]

MedPAC Again Pushes for Home Health Payment Cuts, Highlights Higher Employment Levels

Staffing shortages remain a challenge in home health care. While that’s true, the overall employment pool in home health care is actually larger now than it was before the COVID-19 pandemic. That’s according to the Medicare Payment Advisory Commission (MedPAC), which issued its March 2024 report to Congress on Friday. In addition to including information […]

Home Health Benefit Will Become A ‘Skeleton’ If Medicare Payment Adjustments Continue, Industry Leader Cautions

As the breadth and depth of home health care continues to grow, providers are exposed to an abundance of opportunities. To get a crack at that upside, however, providers will need to overcome and adapt to a litany of challenges. Those that don’t could contribute to the consolidation that the home health industry is already […]

Study: Black Patients Less Likely Receive A Home Health Referral Following A Hospital Stint

Home health services are a vital component of care continuity. But nurses are less likely to give Black patients, compared to white patients, home health referrals when being discharged from a hospital stay, a new University of Michigan study found. Specifically, researchers found that roughly 22% of Black patients were receiving home health referrals by […]

How CMS’ Goal To Enroll All Medicare Beneficiaries In ACOs Could Impact Home-Based Care Providers

The U.S. Centers for Medicare & Medicaid Services (CMS) has stated its objective to enroll all of its Medicare beneficiaries in accountable care relationships by 2030. Currently, roughly 13.2 million Medicare fee-for-service beneficiaries are assigned to an ACO. With this in mind, there has been more activity and investment around accountable care organizations (ACOs), including […]

How Home-Based Medical Care Is Utilized In Traditional Medicare, Medicare Advantage

There are significant differences in home-based medical care utilization between Medicare Advantage (MA) and traditional Medicare beneficiaries. Specifically, having exactly one home-based medical care visit was 31 times as likely for MA beneficiaries, at 18.6%, compared to traditional Medicare beneficiaries at 0.6%. That’s likely, in part, due to incentives in the MA program to code […]

How Home-Based Care Helped The Medicare Shared Savings Program Generate $1.8B In Savings

The Medicare Shared Savings Program (MSSP) continues to save Medicare over a billion dollars annually. And some of the highest-performing, most innovative Accountable Care Organizations (ACOs) participating in the program continue to generate savings by effectively using home-based care. The U.S. Centers for Medicare & Medicaid Services (CMS) announced Thursday that MSSP saved Medicare $1.8 […]