Hospitals improperly coding for post-discharge services contribute to hundreds of millions of dollars in Medicare overpayments. And the majority of incorrect payments are often related to home health services. That’s according to a new audit report from the Department of Health and Human Services (HHS) Office of Inspector General (OIG). The purpose of the OIG […]
Category: Medicare
The Centers for Medicare & Medicaid Services (CMS) has proposed a new rule that would make certain COVID-19-related telehealth flexibilities introduced over the past few months permanent for Medicare beneficiaries. The move comes in conjunction with an executive order from President Trump to improve rural and telehealth access. While CMS’s proposed rule potentially paves the […]
While home-based medical care has been shown to reduce hospitalization rates and lower costs for both homebound and non-homebound populations alike, it continues to be drastically underutilized in the current health care ecosystem. As a result, there are millions of older Americans — especially those living in rural areas — who are going without the […]
Home health providers have experienced varying degrees of disruption to their business models over the past dozen or so years, from the Patient Driven Groupings Model (PDGM) to smaller regulatory changes. But at the end of the day, the cost of doing business has gone up. And reimbursement levels don’t reflect that, according to Mark […]
Home health providers that are looking to tap into new revenue streams may turn to more Medicare Part B services moving forward. But these companies need to have a firm understanding of the reimbursement rules in order for their efforts to be fruitful. The Patient-Driven Groupings Model (PDGM), industry consolidation and the Review Choice Demonstration […]
Health and well-being company Humana Inc. (NYSE: HUM) has spent the past few years adding to its health care services portfolio while aggressively investing around a home-based care strategy. The Louisville, Kentucky-based company has now revealed its latest step in that direction. On Wednesday, Humana announced a wide-ranging strategic partnership with Heal, the in-home primary […]
The impact of the Patient-Driven Groupings Model (PDGM) doesn’t appear to be universal. In fact, each home health care agency’s performance under the model seems to depend on a few somewhat uncontrollable factors, new PDGM data suggests. “CMS created a model that was based on all claims nationally, but depending on where you are and […]
As hospitals continue to experience overcapacity challenges due to the COVID-19 emergency, 911 ambulance crews and community paramedics have found themselves treating more patients at home. Historically, ambulance crews and community paramedics — both of which operate in the emergency medical services (EMS) space — have always provided some degree of care in the home […]
The Centers for Medicare & Medicaid Services (CMS) was a little bit off with some of its predictions related to the Patient-Driven Groupings Model (PDGM). At least, that’s true when it comes to the first four months of 2020, according to Strategic Healthcare Programs (SHP) data unveiled on a recent BlackTree Healthcare Consulting webinar. The […]
The number of Medicare-certified home health agencies in the United States is dwindling — and it’s a trend that started long before the Patient-Driven Groupings Model (PDGM) kicked in. From 2018 to 2019, the number of home health agencies dropped by about 3.6%, a decrease of 427 individual providers, according the Medicare Payment Advisory Commission […]