Understandably, home health providers typically view the Patient-Driven Groupings Model (PDGM) first and foremost as a payment overhaul — the most significant in nearly two decades. But with the right perspective, PDGM can also be leveraged to help drive change, strengthen care planning and improve patient quality outcomes. That’s something home health providers would be […]
Lawmakers are pushing yet another piece of new legislation that would make it easier for patients to gain access to home health care, specifically by widening the scope of who can certify the need for home health services under Medicare rules. A bipartisan group of representatives introduced the Home Health Care Planning Improvement Act of […]
Despite increased oversight efforts, improper payments under Medicare and Medicaid are costing the federal government billions of dollars, a new report from the watchdog arm of Congress has found. And home health providers appear to be the root of the problem. In fiscal year 2018, improper Medicare fee-for-service (FFS) payments totaled $31.6 billion for all […]
One of the most anxiously awaited aspects of the Patient-Driven Groupings Model (PDGM) is the elimination of therapy visit volume as a determining factor in calculating reimbursements. Despite reassurance from industry leaders that PDGM isn’t a ‘death knell’ for therapy services, therapy-heavy agencies will have to become more cost effective to ensure they don’t take […]
The Office of the Inspector General (OIG) is making good on its long-held promise to ramp up oversight of home- and community-based services, requesting an extra $10 million in its fiscal year 2020 budget to tackle fraud, waste and abuse in those areas. The extra funding — which would increase this portion of OIG’s budget […]
There are just nine months to go before the implementation of the Patient-Driven Groupings Model (PDGM), but many home health care agency owners and operators remain uncertain about what the looming payment overhaul will mean for them. On a macro level, all home health agencies are waiting to find out if reimbursement changes will […]
Yet another study has found that home health care has the potential to drastically reduce health care spending and lower readmissions for patients following emergency room visits. Patients in the study who received home health care in-home immediately after going to the ER had a total 90-day cost of $13,012, compared to $20,325 for patients […]
In its latest report to Congress, the Medicare Payment Advisory Commission (MedPAC) recommended cutting the home health reimbursement rate by 5% in 2020 while continuing its push for a unified, site-neutral payment system for all post-acute care providers. Those recommendations are short-sighted and fail to recognize the value that home health care providers have created […]
The Patient-Driven Groupings Model (PDGM) is just nine months from taking the home health care industry by storm. By now, operators should have started preparing for the sweeping adjustments on tap for 2020 — but taking the right steps at the right time is crucial to ensuring success. Among its high-level changes, PDGM removes […]
The Medicare Payment Advisory Commission (MedPAC) submitted its Medicare payment policy report to Congress on Friday, again recommending a 5% home health payment rate reduction for the coming year and maintaining its view that program integrity remains problematic. MedPAC is required to report to Congress each March on the Medicare fee-for-service (FFS) payment systems, the […]
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