Shorter SNF Stays Could Mean More Room for Home-Based Care

Patients recovering at a skilled nursing facility (SNF) can often be discharged home much sooner than they typically are without resulting in a negative health outcome, new research suggests. And if that were to happen more frequently, it could potentially save the U.S. health care system millions of dollars in post-acute care spending while setting […]

CMS Medicare Provider Enrollment Requirements Could Drive Home Health Agencies Out of Business

Changes to the requirements for Medicare provider enrollment could have major consequences for home health providers down the line. Under provider enrollment requirements, the U.S. Centers for Medicare & Medicaid Services (CMS) has the authority to rescind providers’ Medicare enrollment if they are associated with “bad actors” and are at risk for fraud due to […]

New Research Highlights ‘Surprising’ Findings About COVID-19’s Impact on Mortality in Community, Long-Term Care Settings

Since last spring, there has been a consistent — and justifiable — narrative that long-term care residents are particularly vulnerable to the deadly COVID-19 virus. New research, however, suggests it’s not so simple. A team of researchers from the Cleveland Clinic and Health Data Analytics Institute (HDAI) explored how the COVID-19 virus affects actual versus […]

What Home Health Providers Need to Know About Medicare Loan Recoupment

It has been six months since the U.S. Centers for Medicare & Medicaid Services (CMS) gave home health agencies and other Medicare providers a reprieve from having to pay back advance and accelerated payment loans. But recoupment for these loans is just around the corner. To avoid future financial headaches, providers must be prepared to […]

SNF-at-Home Concept Earning ‘Very Positive Feedback’ in Congress, Among Special Interest Groups

An innovative care concept designed to keep patients at home and out of skilled nursing facilities (SNFs) is reportedly gaining ground in Congress and among special interest groups. The concept — known as “Choose Home” — is a type of SNF-at-home model that leverages both medical and non-medical home care services for certain patients. LHC […]

Home Health Profit Margins Projected to Remain Strong in 2021

Margins for Medicare-certified home health agencies are projected to remain strong in 2021, despite ongoing challenges tied to the COVID-19 pandemic and the shift to the Patient-Driven Groupings Model (PDGM). Margins are anticipated to be so robust, in fact, that Congress should reduce the 2021 Medicare base payment rate for home health agencies by 5% […]

CMS Could Target LUPAs, Functional Impairment in Future PDGM Adjustments

Despite the once-in-a-generation COVID-19 pandemic, the home health industry’s transition to the Patient-Driven Groupings Model (PDGM) was pretty seamless. Looking into the not-too-distant future, the U.S. Centers for Medicare & Medicaid Services (CMS) will now likely attempt to make modest tweaks to a handful of key areas, payment experts believe. The agency will do so […]

2% Cut to Home Health Agencies, Other Medicare Providers Nearing Unwanted Return

Among its many provisions, last year’s Coronavirus Aid, Relief and Economic Security (CARES) Act pressed pause on the government’s 2% payment cut to all Medicare-reimbursed health care providers. The “sequestration holiday” was immediately seen as a common-sense lifeline for cash-strapped home health providers on the front lines of the COVID-19 pandemic, many of whom had […]