CMS’s Proposal to Eliminate RAPs, Increase PDGM’s Behavioral Adjustment ‘Death by 1,000 Cuts’

Home health operators and industry advocates are voicing their concerns following a proposal from the Centers for Medicare & Medicaid Services (CMS) to eliminate home health pre-payments and move forward with behavioral assumptions under the Patient-Driven Groupings Model (PDGM). Specifically, many worry the proposed changes will create cash flow problems for home health agencies, which […]

House Lawmakers Looking to Relax Anti-Kickback Rules in Value-Based Care Arrangements

A bipartisan group of U.S. lawmakers is looking to relax federal anti-kickback rules related to how, when and where physicians refer their patients. Doing so could mean smoother referral relationships for home health providers, especially the biggest ones and those operating within an accountable care organization (ACO). Efforts to loosen anti-kickback regulations come from the […]

Why Home Health Therapy Contractor Aegis Isn’t Stressing About PDGM

Among its many changes, the Patient-Driven Groupings Model (PDGM) aims to completely refocus how home health providers are paid for the therapy services they deliver, mainly by moving away from visit volume as the determining factor in calculating reimbursement. When the Centers for Medicare & Medicaid Services (CMS) first proposed PDGM in July 2018, some […]

Lyft Gets Medicaid Certification in Quest to Address Social Determinants of Health

Medicaid beneficiaries in one state can now use Lyft (Nasdaq: LYFT) as a covered transportation option to get to and from medical appointments. The San Francisco-based ride-hailing company announced Wednesday that it has become a certified Medicaid provider in Arizona, where it aims to help address social determinants of health by reducing missed doctor’s visits […]

Payment Overhauls to Bring SNFs, Home Health Providers Closer Together

Similar to home health providers facing the Patient-Driven Groupings Model (PDGM), skilled nursing facility (SNF) operators are months away from a major payment overhaul themselves. Effective beginning Oct. 1, the Patient-Driven Payment Model (PDPM) should trigger more collaboration between the SNF and home health worlds — at least in theory. Understandably, the two complex models […]

Outcry Continues Over Law Allowing Caregivers to Poach Home Care Clients

Home care providers and legislators in one state are voicing concerns about recent legislation that would allow caregivers to poach clients from home care agencies without being penalized. The provision was recently written into the Connecticut state budget. It bans noncompete contracts and similar agreements in “homemaker, companion or home health services.” In other words, […]

Legislation Would Allow Caregivers to Poach Home Care Agencies’ Clients

Home care agencies in one state could soon lose the right to prevent caregivers from poaching their clients, a move opponents worry would devastate providers. A provision recently added to the Connecticut state budget bans noncompete contracts and similar agreements in “homemaker, companion or home health services.” If passed, the legislation would remove home care […]

Nonprofit, Health System-Based Agencies Likeliest to Weather PDGM’s Therapy Storm

A huge portion of existing home health agencies will have to rethink how they delivery therapy services in 2020 in response to the Patient-Driven Groupings Model (PDGM) and its sweeping changes. But nonprofit and health system-affiliated home health agencies appear well-positioned to weather the PDGM therapy storm. That’s according to recent findings from a survey […]