Medicare-certified home health agency supply continued to grow in 2024, but much of that expansion was concentrated in California — particularly Los Angeles County, an area previously identified by the California state auditor as a major hotspot for hospice fraud, waste and abuse — according to the Medicare Payment Advisory Commission (MedPAC). California, and Los […]
Category: Medicare
On Tuesday, the Centers for Medicare & Medicaid Services (CMS) proposed shifts to Medicare’s Shared Savings Program (MSSP), accountable care organizations (ACOs) and physician payment structure with the broad goal of propelling a shift toward value-based care. The proposed changes, which include allowing ACOs with approved applications to decrease or cut beneficiary out-of-pocket costs for […]
The Centers for Medicare & Medicaid Services’ (CMS) proposed home health payment rule for CY2027 is a mixed bag for providers and industry insiders, offering a long-awaited raise alongside the sting of unresolved retroactive cuts. Experts told Home Health Care News that while the proposed aggregate payment increase of 2.4% could suggest that CMS’ home […]
UnitedHealth Group’s (NYSE: UNH) in-home health program, HouseCalls, coincided with up to 5% fewer inpatient stays and 4% fewer emergency room visits for older adults with conditions such as diabetes and hypertension in the year after their visit, according to a Tuesday announcement. In the announcement, the healthcare giant shared initial results of an external […]
The 2027 Medicare home health proposed payment rule dropped yesterday, and it was a surprising one. The home health industry has become accustomed to years of proposed cuts – but this one featured an aggregate rate increase. In the last two proposed rules, CMS floated aggregate cuts of 6.4% and 1.7%, making the 2027 proposal […]
Bayada Home Health Care’s new CEO, Bryony Winn, is targeting close to double-digit annual growth over the next several years, with a strategy centered on expanding the provider’s footprint, deepening its value-based care capabilities and taking on more financial risk — though not always through direct contracts with payers. Among Winn’s top priorities for Bayada […]
The decentralized nature of home health services leaves providers and payers vulnerable to extreme weather, and new research shows that hurricane floods can tack nearly two weeks onto treatment times. Hurricanes and related flooding were associated with delays to home health services, longer treatments and lower rates of successful return to patients’ communities, according to […]
Home-based care coordination platform Hera has raised $27 million in a Series A funding round led by Bain Capital Ventures, with participation from Accel and IA Ventures and angels including the chief financial officer of Mount Sinai. The company’s care coordinators – called Heroes – manage the non-clinical but often complicated work of caring for […]
The Centers for Medicare and Medicaid (CMS) has experimented with pre-claim review processes — and new research suggests that this Medicare program can be highly effective, but only in certain states. Medicare pre-claim reviews for home health services cut spending in Illinois by 13% and reduced an estimated $1.2 billion in traditional Medicare home health […]
At last week’s PAYER Summit, providers, policy experts and payer execs were largely aligned on what will separate successful home-based care organizations from the rest of the pack. Discussions at the event, hosted by Home Health Care News and Skilled Nursing News, included commentary on some notable changes in the payment landscape that have occurred […]
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