CMS Pumps Brakes on Primary Care First Launch

When the Centers for Medicare & Medicaid Services (CMS) unveiled its new voluntary risk-based in-home primary care initiative in April, home health providers and advocates responded with cautious optimism. For some, that optimism will now have to be put on hold. Although CMS is now accepting applications to participate in its Primary Care First payment […]

Despite Challenges, Some See Upside in PDGM’s Therapy Overhaul

The Patient-Driven Groupings Model (PDGM) is still months away, but its projected impact on therapy utilization is already sending shockwaves throughout the home health industry. With an eye toward 2020, many providers anticipate cutting back on therapy and shifting their business models more toward nursing services, especially when it comes to higher-paying areas such as […]

Home Health Advocates Strike Key Victory, Win RCD Delay

Home health advocates have struck an important victory in the battle against the Review Choice Demonstration (RCD). The Centers for Medicare & Medicaid Services (CMS) announced Monday that the agency will delay RCD until March 2. The demonstration had previously been targeted for a Dec. 2 start date, meaning Texas home health providers would have […]

Home Health Industry Has ‘Very Limited Chance’ of Derailing CMS’s RAP Plans

Home health agencies hoping the industry will derail the Centers for Medicare & Medicaid Services (CMS) in its quest to eliminate pre-payments shouldn’t hold their breath. In its July 11 proposed payment rule, CMS floated plans to phase out Requests for Anticipated Payment (RAPs) starting next year and eliminate them completely by 2021. The agency […]

PDPM Aftermath Offers Glimpse of Home Health Therapy Changes to Come

Home health operators wondering how therapy utilization will change following the Jan. 1 implementation of the Patient-Driven Groupings Model (PDGM) need only look to their post-acute care brethren for answers. The beginning of October marked the official start of the Patient-Driven Payment Model (PDPM), another major payment overhaul from the Centers for Medicare & Medicaid […]

Top Roadblocks Impeding Home Care Providers’ Ability to Coordinate Services

As the health care system continues to move toward a value-based model, at-home care providers are eager to show their worth. Many hope to do that in part by coordinating with clinical and community partners to deliver holistic care and improved patient outcomes. But despite those ambitions, care coordination is easier said than done. “Projects […]

Crisis Averted: Court Strikes Down Rate Changes Set to Compound Caregiver Shortage

Regulatory changes that threatened to compound the caregiver crisis in one state have been reversed, after a judge declared them “null and void.” The news comes more than a month after a new rate structure took effect to govern the Consumer-Directed Personal Assistance Program (CDPAP) in New York. CDPAP allows seniors and people with disabilities […]

HIPAA Compliance, Domestic Workers Bill of Rights Emerging as Key Home Care Legal Issues

In order to avoid costly legal issues, in-home care providers need to stay on top of the constantly evolving legislation landscape. A major part of this is being proactive and getting in front of compliance before it becomes an issue, according to Angelo Spinola, attorney and shareholder at San Francisco-based legal firm Littler Mendelson. “The […]

NAHC’s Dombi: We’re Not Going To Be Bullied By Congress, CMS

There’s a flood of changes surging toward the U.S. home health care industry. But thanks to widespread recognition, improved quality and staunch advocacy efforts, providers have never been standing on higher ground. That was the key message delivered by the National Association for Home Care & Hospice (NAHC) leadership Sunday during the Washington, D.C.-based nonprofit […]

PDGM 101: Advice for Small-Scale Home Health Agencies

The Patient-Driven Groupings Model (PDGM) is less than three full months away. Among its biggest changes, PDGM halves the traditional 60-day billing period to 30 days and places greater emphasis on coding with a new 432-point case-mix mechanism. If those two changes weren’t enough, the overhaul also comes with a potential 8% behavioral adjustment cut […]