NAHC’s Dombi: CMS Needs to ‘Back Off’ RAP Proposal, PDGM Assumptions

The looming Patient-Driven Groupings Model (PDGM), a potential hospice carve-in under Medicare Advantage (MA) and the expanding Review Choice Demonstration (RCD) are just a few of the developments reshaping the current landscape of home health and hospice. As if those three items aren’t enough, providers are also facing the continuing Value-Based Purchasing Model (VBPM), emerging […]

CMS’s Proposal to Eliminate RAPs, Increase PDGM’s Behavioral Adjustment ‘Death by 1,000 Cuts’

Home health operators and industry advocates are voicing their concerns following a proposal from the Centers for Medicare & Medicaid Services (CMS) to eliminate home health pre-payments and move forward with behavioral assumptions under the Patient-Driven Groupings Model (PDGM). Specifically, many worry the proposed changes will create cash flow problems for home health agencies, which […]

Non-Medical Home Care Could Save At Least $4B in Medicare Costs

Non-medical home care benefits that address the social determinants of health of older adults could curb Medicare spending. That’s according to findings from a recent study published in the Annals of Internal Medicine, which suggests more than $4 billion in Medicare costs are due to the lack of non-medical support for older adults, specifically those […]

Home Care Providers in These States May Be Best Positioned for Medicare Advantage

Medicare Advantage (MA) enrollment is expected to skyrocket in coming years, with more than one-third of Medicare beneficiaries currently signed up. But the pace of the great MA migration may be slower than originally anticipated — and vastly different across state lines. For home care providers, this means there could be fewer older adults with […]

OIG: ACOs Need to Get Better at Health IT

Technology is key to helping accountable care organizations (ACOs) coordinate better patient care — yet ACOs still aren’t leveraging health IT to its full potential. That’s according to a report from the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG). OIG officials interviewed providers and staff from six different ACOs […]

Dual-Eligible Medicare Advantage Beneficiaries Have Greatest Social Determinants of Health Needs

Addressing social determinants of health is especially important for Medicare Advantage (MA) beneficiaries, as they are increasingly affected by a lack of services targeting those needs, which include access to and quality of housing, food and transportation, among other socio-economic factors. That’s according to a recent report from Avalere Health, a Washington, D.C.-based health care […]

Amedisys Execs Share Action Plan for ‘Worst Form’ of PDGM

Despite being one of the largest and most powerful home health companies in the game, Amedisys Inc. (Nasdaq: AMED) isn’t immune to the uncertainty that comes with the looming Patient-Driven Groupings Model (PDGM). The Baton Rouge, Louisiana-based provider has a plan of action, even if the model goes into effect on Jan. 1 as is […]