As the federal government cracked down on home-based care fraud, HealthView got swept up in the maelstrom. 2026 proved to be a difficult year, but HealthView survived by relying on cash reserves it built in anticipation of tougher market conditions, CEO Steven Gonzalez and Vice President of Clinical Operations Monica Cutia told Home Health Care […]
Home-based care providers are operating in an environment of intensified Medicare and Medicaid program integrity oversight and transformational AI technology. The companies that survive and thrive are the ones that adopt AI with disciplined governance, compliance and vendor management. Companies should respond to the evolving regulatory landscape by conducting internal data reviews and compliance checks, […]
The National Alliance for Care at Home’s (the Alliance) new chief government affairs officer, Denis Fleming Jr., sees an unprecedented upswell of bipartisan support among lawmakers for home-based care — an environment he describes as the “greatest opportunity” yet for providers. At the same time, Fleming is closely watching rising threats to access to care, […]
The home-based care industry is shifting fast, with major leadership changes, new technologies changing the operational game and a significantly different regulatory landscape, including a federal-level fraud crackdown. Those are big, sometimes abstract forces. But what matters most is how provider leaders show up in an organization’s day-to-day operations: the referral documents someone has to […]
On Tuesday, the Centers for Medicare & Medicaid Services (CMS) proposed shifts to Medicare’s Shared Savings Program (MSSP), accountable care organizations (ACOs) and physician payment structure with the broad goal of propelling a shift toward value-based care. The proposed changes, which include allowing ACOs with approved applications to decrease or cut beneficiary out-of-pocket costs for […]
The Centers for Medicare & Medicaid Services’ (CMS) proposed home health payment rule for CY2027 is a mixed bag for providers and industry insiders, offering a long-awaited raise alongside the sting of unresolved retroactive cuts. Experts told Home Health Care News that while the proposed aggregate payment increase of 2.4% could suggest that CMS’ home […]
The 2027 Medicare home health proposed payment rule dropped yesterday, and it was a surprising one. The home health industry has become accustomed to years of proposed cuts – but this one featured an aggregate rate increase. In the last two proposed rules, CMS floated aggregate cuts of 6.4% and 1.7%, making the 2027 proposal […]
When CMS announced its proposed quality measures for Medicaid home- and community-based services (HCBS) for 2028, I was a little surprised by the tone of many of the measures. Metrics like “People Realize Personal Goals” and “People Participate in the Life of the Community” stood in contrast to the “harder” data I’ve grown accustomed to […]
The home- and community-based services industry has changed drastically over the last decade, from different payer mixes to new service line opportunities. To navigate Medicaid budget cuts and other uncertainties, providers must adjust operations, improve data collection and tell compelling stories to advance the industry, according to experts on a recent Home Health Care News […]
The Medicare home health final payment rule for calendar year 2026 has been most discussed for its methodology and its 1.3% aggregate rate cut, but other aspects of the final rule require home health providers to carefully strategize for the upcoming year. In the final rule, the Centers for Medicare and Medicaid Services (CMS) recalibrated […]
