In-Home Care Providers ConcertoHealth, Perfect Health Merge to Form ‘ConcertoCare’

Two in-home care providers — ConcertoHealth and Perfect Health — announced Wednesday that their organizations have merged. Together, the companies will operate under the name “ConcertoCare.” Aliso Viejo, California-based ConcertoHealth is a value-based care provider organization that delivers a variety of home-based care services. The company’s teams consist of complex care physicians, complex care nurses, […]

MACs Report Processing Glitches for No-Pay RAPs

Among payment-related policy changes for the home health industry in 2021 is the elimination of traditional Requests for Anticipated Payment (RAPs) — and the introduction of the “no-pay RAP.” While the change is a potentially costly one for home health agencies, they’re not the only ones struggling to keep up. Medicare Administrative Contractors (MACs) have […]

MA Beneficiaries See Nearly 20% Fewer Home Health Days Than Traditional Medicare Peers

Under the Trump administration, federal health care policymakers have long been vocal about the ability of Medicare Advantage (MA) to lower costs and improve outcomes among vulnerable populations. A recent report from the Washington, D.C.-based Better Medicare Alliance (BMA) and consulting firm Avalere Health is now putting hard numbers on that claim, particularly around home […]

House Bill Looks to Keep Medicare Sequestration ‘Holiday’ in Place for Home Health Agencies, Others

U.S. Representatives Brad Schneider (D-Ill.) and David McKinley (R-W.Va.) introduced the Medicare Sequester COVID Moratorium Act last week. If passed, the bill would extend the temporary suspension of Medicare sequestration payment reductions, giving home health agencies and other providers more financial flexibility headed into an uncertain 2021. Since 2014, the U.S. Centers for Medicare & […]

MedPAC: ‘Dynamic’ Home Health Industry Is Evolving into ‘Multiple Types of Care’

The home health industry is in a “dynamic state” and evolving into “multiple types of care,” according to the Medicare Payment Advisory Commission (MedPAC). As a result, health care policymakers should start thinking about how to redesign the traditional home health benefit to make it more nimble, perhaps by breaking it up into pre-acute and […]

SCAN Group Takes on Telehealth’s ‘Digital Divide,’ Moves Further into the Home

As mission-driven organizations, SCAN Group and SCAN Health Plan have leaned into trying to solve some of health care’s biggest problems. In particular, keeping seniors independent and healthy at home has been a major area of focus. SCAN Group is a nonprofit organization focused on helping older adults age in place. Founded in 1977, Long […]

‘Our Work Begins with Getting COVID Under Control’: What a Biden Administration Means for Home-Based Care

After one of the closest and most hotly contested campaigns in modern history, President-Elect Joe Biden addressed the nation on Saturday from an outdoor platform in Wilmington, Delaware. While it’s far too early to say what the first 100 days of a Biden administration will look like from a detailed policy perspective, the president-elect has […]

Late RAPs Could Trigger Immediate 20% Payment Reduction in 2021

The U.S. Centers for Medicare & Medicaid Services (CMS) released its final home health payment rule for CY 2021 on Thursday, with essentially no changes to the Patient-Driven Groupings Model (PDGM) or its controversial behavioral adjustment.  In addition to doubling down on PDGM, boosting the home health base payment rate by 1.9% and making minor […]