Amid the U.S. Department of Justice’s (DOJ) legal battle with UnitedHealth Group (NYSE: UHG) regarding the planned purchase of Amedisys (Nasdaq: AMED), the company is also now reportedly facing an investigation for a different matter. The DOJ is currently pursuing a civil fraud investigation focused on the company’s practices for recording diagnoses that activate extra […]
Category: Medicare
On Wednesday, Rep. Andrew Clyde (R-Ga.) introduced a resolution — H. J. RES. 58 — for congressional disapproval of the 2025 home health payment rule. Last November, the U.S. Centers for Medicare & Medicaid Services (CMS) unveiled its home health final payment rule for 2025. The rule included an 0.5%, or $85 million, estimated aggregate […]
The Senate confirmed Robert F. Kennedy Jr. as Secretary of the Department of Health and Human Services (HHS) on Thursday, in a 52-48 vote. The National Alliance for Care at Home (the Alliance) stated its intention to work with Kennedy and HHS on a variety of policy priorities, with particular reference to advancing “policies that […]
The Comprehensive Care for Joint Replacement (CJR) model has had a modestly positive effect on how often joint replacement patients receive home health care, but “sizeable portions” of these patients still “miss out” on such services. This is according to study findings recently published in the American Journal of Managed Care. To enhance care coordination […]
End-of-life home health care use and duration are lower among Medicare Advantage (MA) enrollees compared to traditional Medicare enrollees across nearly all populations. This is especially true among Hispanic people and people identifying as Asian or Pacific Islander, according to a research letter published in the Journal of the American Medical Association. Researchers found that […]
Home health agencies (HHAs) owned by private equity (PE) firms tend to outperform agencies not owned by PE in certain metrics while lagging in others. That’s according to a recent study by Mohammad Ishtiaque Rahman, an assistant professor of computer information systems at Thomas More University in Crestview Hills, Kentucky. The analysis found that HHAs […]
The landscape of home health care is evolving through the introduction of two key models designed to improve patient outcomes and reduce costs: the expanded Home Health Value-Based Purchasing (HHVBP) model and the Targeted Episode-Based Medicare Access and Payment (TEAM) model. These initiatives incentivize home health agencies to provide high-quality, coordinated care while addressing the […]
For the second consecutive year, the Medicare Payment Advisory Commission (MedPAC) has issued a draft recommendation advising Congress to reduce Medicare payments to home health agencies by 7% beginning in 2026. During its December meeting, MedPAC discussed the adequacy of Medicare payments across various provider settings and reviewed its draft recommendations to Congress regarding payment […]
Residents in neighborhoods with lower socioeconomic status were more likely to use lower-quality home health agencies, according to a recent study by researchers at the University of Georgia, Athens. Using data from the Outcome and Assessment Information Set (OASIS), Area Deprivation Index and Patient Care Star Ratings, researchers examined 1,657,133 Medicare beneficiaries who received home […]
A new analysis by the Kaiser Family Foundation (KFF) reveals that Medicare spending is higher for beneficiaries who switch from Medicare Advantage (MA) to traditional Medicare compared to similar beneficiaries who have continuously been enrolled in traditional Medicare. These beneficiaries cost Medicare an average of 27% more, according to the analysis, which examined health costs […]
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