Home Care Providers in These States May Be Best Positioned for Medicare Advantage

Medicare Advantage (MA) enrollment is expected to skyrocket in coming years, with more than one-third of Medicare beneficiaries currently signed up. But the pace of the great MA migration may be slower than originally anticipated — and vastly different across state lines. For home care providers, this means there could be fewer older adults with […]

OIG: ACOs Need to Get Better at Health IT

Technology is key to helping accountable care organizations (ACOs) coordinate better patient care — yet ACOs still aren’t leveraging health IT to its full potential. That’s according to a report from the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG). OIG officials interviewed providers and staff from six different ACOs […]

Dual-Eligible Medicare Advantage Beneficiaries Have Greatest Social Determinants of Health Needs

Addressing social determinants of health is especially important for Medicare Advantage (MA) beneficiaries, as they are increasingly affected by a lack of services targeting those needs, which include access to and quality of housing, food and transportation, among other socio-economic factors. That’s according to a recent report from Avalere Health, a Washington, D.C.-based health care […]

Amedisys Execs Share Action Plan for ‘Worst Form’ of PDGM

Despite being one of the largest and most powerful home health companies in the game, Amedisys Inc. (Nasdaq: AMED) isn’t immune to the uncertainty that comes with the looming Patient-Driven Groupings Model (PDGM). The Baton Rouge, Louisiana-based provider has a plan of action, even if the model goes into effect on Jan. 1 as is […]

Home Health Audits Expected to Spike in PDGM Aftermath

Home health providers from coast to coast are scrambling to prepare their operations ahead of the Patient-Driven Groupings Model (PDGM) — but what comes after the new model’s implementation could cause agencies an even bigger headache. In the months after PDGM goes into effect, home health audits — much like bankruptcies — are expected to […]

Creative PDGM Therapy Strategies for Home Health Agencies

When the Patient-Driven Groupings Model (PDGM) takes effect on Jan. 1, 2020, therapy-heavy home health agencies will have to get creative to ensure the new model doesn’t hurt their bottom line.   PDGM eliminates therapy-visit volume as a determining factor in calculating reimbursements, meaning therapy will no longer be a guaranteed revenue-driver for home health […]

[Updated] Industry Insiders: Don’t Overlook CMS’s Dual-Eligibles Directive

*Editor’s note (4/30/2019): This story has been updated to include comments from Hometeam CEO Randy Klein. Home-based care providers continue to show their support for the Centers for Medicare & Medicaid Services’ (CMS) move to better coordinate care for Americans who qualify for both Medicare and Medicaid. CMS first announced plans to expand coverage options […]

Addus Exec: CMS’s Dual-Eligibles Move Encouraging for In-Home Care Providers

The Centers for Medicare & Medicaid Services (CMS) announced plans Wednesday to expand coverage options for Americans who qualify for both Medicare and Medicaid, giving states the freedom to develop their own programs for dual-eligible beneficiaries. While the directive doesn’t outline specific opportunities for home-based care providers, the move is still encouraging for the industry, […]