Lenders See Positives in Proposed RAP Phase Out

Industry experts predict that a potential phase out of home health Requests for Anticipated Payments (RAPs) will likely put several small to mid-size providers out of business. But not everybody is lamenting the Centers for Medicare & Medicaid Services (CMS) proposal. Amedisys Inc. (Nasdaq: AMED) and other large home health providers, for example, have spun […]

Financial Crisis Puts Quality Care Services in Survival Mode

An ongoing financial crisis related to phone troubles has put a Texas home health agency “on life support,” according to a local news report. The story further reveals how even a seemingly small disruption to cash flow can put home health providers with tight operating margins underwater. Opened more than two decades ago, Beaumont, Texas-based […]

Home-Based Kidney Care Company Provides Framework for In-Home Renal Treatment

A value-based kidney care company is showing what’s possible when it comes to renal treatment in the home — potentially providing a framework for home-based care providers if a variety of newly proposed payment models come to fruition. Since getting started about three-and-a-half years ago, Vienna, Virginia-based Somatus Inc. has served 3,000 patients, doing more […]

Counterpoint: Elimination of RAPs Isn’t a ‘Sky-Is-Falling Issue’

Since the Centers for Medicare & Medicaid Services (CMS) announced its proposal to phase out Requests for Anticipated Payments (RAPs) last month, home health providers have voiced their concerns about what the change will mean for them. Industry-wide, the consensus isn’t good. Many providers worry the removal of RAPs, in addition to the other regulatory […]

Ohio Home Health Agencies Are Next in Line for the Review Choice Demonstration

The Review Choice Demonstration (RCD) is expanding. The Centers for Medicare & Medicaid Services (CMS) announced Monday that home health providers in Ohio will be next in line for RCD, a revived version of the failed Pre-Claim Review Demonstration (PCRD) meant to combat improper billing. Home health providers in Illinois — the only state with […]

Encompass Health’s April Anthony: PDGM Isn’t a ‘Free Pass’ for Breaking Coding Rules

Encompass Health Corp. (NYSE: EHC) has lowered internal estimates on how the Patient-Driven Groupings Model (PDGM) will impact its home health operations, though the company remains firmly against assumption-based behavioral adjustments included in the payment overhaul. CEO Mark Tarr — along with home health and hospice segment leader April Anthony as well as other execs […]

PDGM Check-In: ‘There’s a Slight Sense of the Wild West’

With just five full months to go before the Patient-Driven Groupings Model (PDGM) becomes a reality, home health providers have reached crunch time. As it has been all along, the assumption-based behavioral adjustment baked into PDGM remains the home health industry’s No. 1 issue. Orginally, the behavioral adjustment was estimated to create a 6.42% payment […]

OIG Calls for Additional Oversight of Home Health, Personal Care Service Providers

In a new report released Monday, the U.S. Department of Health and Human Services Office of Inspector General (OIG) highlighted dozens of its unimplemented recommendations for reducing fraud, waste and abuse throughout the Medicare and Medicaid systems. Many of the recommendations were tied to home health, hospice and personal care services, in addition to how […]