False Alarm: Why Small Home Health Agencies Should Tune Out PDGM ‘Carnage’ Claims

Home health industry insiders throughout 2019 have frequently speculated on the “carnage” likely to take place next year when the Patient-Driven Groupings Model (PDGM) pushes smaller, ill-equipped agencies out of business. Generally, the narrative goes something like this: As the biggest overhaul to home health reimbursement in two decades, PDGM will significantly disrupt agency cash […]

Where PDGM’s Therapy Changes Will Hit Hardest

By eliminating visit-volume thresholds and tying reimbursement more closely to need, the Patient-Driven Groupings Model (PDGM) will likely steer the home health care industry away from therapy and toward nursing. Although PDGM officially starts on Jan. 1, home health providers have already begun to shift their therapy utilization strategies to better line up with the […]

Despite $5.32B Decrease, CMS Likely to Keep Foot on Improper Payments Gas Pedal

The Medicare fee-for-service improper payment rate has fallen once again, thanks largely to the cleaner paperwork and ongoing compliance efforts of U.S. home health providers. Despite clear and steady progress in bringing improper payment rates down, though, the Centers for Medicare & Medicaid Services (CMS) is unlikely to relax its oversight anytime soon, industry leaders […]

BrightStar CEO: What Non-Medicare Home Care Providers Should Know About PDGM

With a focus on institutional referrals and changes to therapy reimbursement, the Patient-Driven Groupings Model (PDGM) is going to rock the Medicare-certified home health world in 2020. But private-pay and non-medical home care agencies may also see bottom-line impacts tied to PDGM. Specifically, PDGM will likely create new opportunities for home care agencies looking to […]

PDPM Speed Bumps Hint at Unexpected PDGM Challenges to Come

With less than two months left on the clock before home health agencies take their shot at the Patient-Driven Groupings Model (PDGM), questions regarding industry preparedness and education continue to swirl. Some, however, say those questions are better aimed at the Centers for Medicare & Medicaid Services (CMS). Similar to home health providers, CMS regulators […]

LHC Group CEO Calls for Medicare Payment Transparency as Company Hits Major Milestone

LHC Group Inc. (Nasdaq: LHCG) — one of the two largest, independent home health, hospice and personal care companies in the U.S. — has hit a major milestone in its 25-year history. The Lafayette, Louisiana-based company officially crossed the 100,000-patient mark. In addition to being a personal achievement for Chairman and CEO Keith Myers — whose […]

Home Health Industry Gains Ground After Final Rule — But PDGM Behavioral Adjustment Battle Isn’t Over

The Centers for Medicare & Medicaid Services (CMS) released the 2020 home health final payment rule on Oct. 31, reaffirming many aspects of next year’s payment overhaul while also updating certain quality reporting metrics and solidifying changes to policymakers’ maintenance therapy proposal. The National Association for Home Care & Hospice (NAHC) and Axxess were among […]

Post-Acute Care ‘Food Fight’ Brewing in Washington

There’s a political food fight brewing in the nation’s capital, health care policy insiders told Home Health Care News. And a possible overhaul to the entire post-acute care (PAC) sector is to blame. “One of the things I’m hearing out of Washington is that there are some stakeholders in the post-acute care space interested in […]

Encompass Health CEO: CMS Shouldn’t Risk Home Health Industry Destabilization

The Centers for Medicare & Medicaid Services (CMS) shouldn’t risk home health industry destabilization while pushing through its proposed version of the Patient-Driven Groupings Model (PDGM), especially when it comes to the overhaul’s looming 8.01% behavioral adjustment. That’s according to Encompass Health Corporation (NYSE: EHC) President and CEO Mark Tarr, who discussed PDGM and his […]

Home Health Providers: Beware of CMS’s PDGM Pendulum Swing

Home health providers looking to bet the farm that the Patient-Driven Groupings Model (PDGM) goes through in its current form should be warry, industry executives say. Although it’s important to adjust to the upcoming payment overhaul, the Centers for Medicare & Medicaid Services (CMS) has a history of changing its tune after regulatory actions trigger […]