Maintaining a place in a Medicare Advantage payer’s network requires far more than signing an agreement. Providers need to demonstrate reliable access, quality outcomes and a willingness to work with plans on an ongoing basis — increasingly through timely performance data and regular communication, industry experts said during PAYER Summit in June. “I often see […]
Technology now helps home health care providers catch errors before they reach the payer — but issues such as incomplete documentation or missing clinician signatures can still cause delays. The process begins with intake and eligibility, then continues through clinical documentation, assessments, coding and claim submissions, experts told Home Health Care News. “Billing starts the […]
Aveanna Healthcare Holdings (Nasdaq: AVAH) hit its preferred payer goals ahead of schedule and plans to push deeper into its fastest-growing segment — home health and hospice — through additional acquisitions. Improved federal government affairs and preferred payer results largely drove the company to update its previous 5% to 7% home health and hospice organic […]
Medicare Advantage (MA) is at an inflection point, prompting home-based care providers to rethink how they grow and whom they contract with. Plans and providers both need to adapt to changing MA trends, according to experts at Home Health Care News’ PAYER Summit. For providers, that could mean prioritizing collaborative payer relationships and, in some […]
UnitedHealthcare is seeking to improve care continuity in rural communities, including initiatives that could support community- and home-based care. UnitedHealth Group’s (NYSE: UNH) insurance arm also reported decreases in skilled nursing facility (SNF) admissions and described efforts to reduce prior authorizations in its Q1 earnings call on Wednesday. “We are intensifying our efforts to help […]
Leaders of health care organizations risk obsolescence or getting lost in the “middle management” aspect of their work – unless they follow ethical principles designed to root out toxicity. This is according to SCAN Group CEO Dr. Sachin Jain. SCAN Group is a non-profit Medicare Advantage organization and parent company of SCAN Health Plan, a […]
The Medicare Payment Advisory Commission (MedPAC) has voted to approve a draft recommendation that would reduce the Medicare base payment rate for home health care services for calendar year 2027 by 7%. The draft recommendation, released in December and approved on Wednesday, would reduce home health Medicare spending by $750 million in one year and […]
Aveanna Healthcare Holdings (NASDAQ: AVAH) is focusing on density and its preferred payer agreements as it scopes out potential acquisitions in 2026 – and is not shying away from home health deals now that the CY2026 Medicare home health payment rule offers a level of certainty. CEO Jeff Shaner is scouting tuck-in deals to “densify” […]
Demand for home-based care services remains steady – but little else in the industry does. With rapidly advancing technology, looming threats such as the proposed home health rate cut and regulatory shifts like the companionship exemption, providers today are navigating an unprecedented mix of challenges and opportunities. Amid significant disruption, providers are finding ways to […]
Over the years, health insurers have increasingly purchased health care providers, creating monolithic “payvider” organizations. This consolidation has captured the home health industry’s careful attention, and several stories on this trend have been among the most-read on Home Health Care News in the last month. Some of those stories have reflected the ongoing growth of […]
