Medicare Advantage Beneficiaries Eagerly Await New Home Care Coverage

More than half of all Medicare Advantage (MA) members want their plans to cover assistance at home, according to a new survey. But despite new rules allowing it, the majority of beneficiaries will have to wait until 2020 or later for their plan to have that option. Fifty-seven percent of members surveyed by HealthMine Medicare […]

Brookdale Petitions Supreme Court to Review $35 Million Whistleblower Lawsuit

Brookdale Senior Living (NYSE: BKD), one of the largest home health providers in the nation, has petitioned the U.S. Supreme Court to review a case involving allegations of fraudulent Medicare billings totaling about $35 million. The lawsuit was filed in 2012 by Marjorie Prather, a former employee of Brentwood, Tennessee-based Brookdale. Prather alleged that Brookdale […]

Health Plans: Mixed Messages, Lack of Clarity Hinder MA Change Adoption

Despite high levels of interest, several roadblocks are preventing a bigger, broader rollout of new supplemental benefits, including ones related to home care, soon to be available under Medicare Advantage (MA) in 2019. Those roadblocks, according to MA plans, include a general lack of regulatory clarity, mixed messages from federal policymakers and a tight deadline. […]

Trumpeted New Medicare Advantage Benefits Will Be Hard For Seniors To Find

Home Health Care News Perspective: With certain non-skilled in-home care services allowable under the Medicare Advantage program in 2019, the home care industry has made landing partnerships with health plans a top priority. But significant opportunities may not arise until 2020, experts predict. Just 3% of MA plans will next year offer in-home support services such as […]

[Updated] CMS Finalizes PDGM and $420 Million Increase for 2019 Medicare Payments

Despite industry concerns, the Centers for Medicare & Medicaid Services (CMS) has finalized the Patient-Driven Groupings Model (PDGM) planned to start in 2020. The agency has also finalized several other changes to how home health providers are reimbursed for their services starting in 2019, tweaking remote patient monitoring rules and refining the Value-Based Purchasing Model […]

Researchers Identify Optimal Number of At-Home PT Visits for Knee Patients

In-home physical therapy (PT) helps knee replacement patients recover more successfully, with six to nine PT visits being a generally optimal level of treatment. That’s according to research findings from the University of Colorado School of Medicine, recently published in the Journal of Bone and Joint Surgery. A team of physical therapists analyzed Medicare home […]

HHS: Medicare Advantage Plans Improperly Denying Claims

Roughly one-third of Medicare beneficiaries are currently signed up for Medicare Advantage (MA) plans, the private-insurance alternative to the traditional Medicare program. That figure is growing rapidly, too, especially as more Americans become aware of the non-medical, at-home care services available through MA plans as supplemental benefits starting in 2019. While popular, the MA program […]

Home Health Quality on the Upswing, Readmission Rates Hold Steady

The quality of home health care improved across most major domains between 2016 and 2017, although the rate of hospital admissions remained static for the fifth straight year. That’s according to data in the Home Health Chartbook 2018, prepared by Avalere Health for the Alliance for Home Health Quality and Innovation. The document compiles data […]

Anthem Adds Home Care Benefits Under Relaxed Medicare Advantage Rule

Home care providers have been wondering how insurers will capitalize on the allowance of non-skilled in-home care services under the Medicare Advantage (MA) program since policymakers initially opened that door in early spring. They’re now starting to get some clarity, thanks to Anthem, Inc. (NYSE: ANTM), one of the top players in the MA market. […]