The U.S. Centers for Medicare & Medicaid Services (CMS) in 2026 plans to raise payments to Medicare Advantage plans by 4.3% in 2026. CMS has issued an advance notice of policy changes for Medicare Advantage and Part D that would install technical updates, including to the ways the agency calculates payments to health plans. “CMS […]
One of the publicity issues home-based care faces is that most people don’t even understand the difference between home health care and home care, much to the chagrin of industry veterans in both sectors. But in the future, those same leaders are bullish on the merging of those two types of care. Home care and […]
Formerly U.S. Medical Management, the home-based care company HarmonyCare raised $200 million in June. On Wednesday, it touted its success in the Accountable Care Organization (ACO) “REACH” Model, the successor to the The Global and Professional Direct Contracting Models (GPDC). Put forth by the Centers for Medicare & Medicaid Services (CMS), ACO REACH gives private […]
Medicare Advantage (MA) star ratings have become a hot topic for Humana Inc. (NYSE: HUM). On Oct. 18, the company filed a lawsuit against the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) over its drop in star ratings. The number of Humana MA plans rated […]
The Centers for Medicare & Medicaid Services’ (CMS) Medicare rate cuts, state-driven Medicaid member redeterminations and the Change Healthcare cyberattack. These are just three disruptions that UnitedHealth Group’s (NYSE: UNH) leadership has had to factor in when setting future growth objectives. “It’s a distinctive part of the culture of UnitedHealth Group that we continue to […]
As more home health providers participate in value-based care arrangements, leaders are learning what works, and what falls flat. Enhabit Inc. (NYSE: EHAB) has been active in the value-based care space. The company has a small – but growing – number of value-based contracts on the Medicare Advantage (MA) side, as well as Accountable Care […]
Earlier this year, I had the chance to interview CenterWell President Sanjay Shetty on stage and off stage at the Digital Healthcare Innovation Summit in La Jolla, California. Last month, at Home Health Care News’ FUTURE conference in Nashville, I did the same with Kirk Allen, the president of home solutions at Humana Inc. (NYSE: […]
Home health providers often pursue value-based care arrangements, with the goal of delivering quality care and achieving monetary success. But if they are not careful, these companies can also land in financial hot water. “In a value-based arrangement, a financial disaster means I’m now losing money,” Joseph Furtado, administrator of MD Home Health, told Home […]
The senior care company Lifespark has been building out its value-based care model for years. Now, it has added in-home urgent care, a key service line for a company taking on upside and downside risk. Ultimately, the goal is to reduce unnecessary emergency room visits or hospitalizations. The urgent care service line will be added […]
Following its move to decrease VillageMD’s physical footprint, Walgreens Boots Alliance Inc. (Nasdaq: WBA) seems to be doubling down on its decision. “We don’t have plans to continue to invest in brick and mortar-owned primary care practices,” Mary Langowski, the president of U.S. Healthcare, said during the company’s third-quarter earnings call on Thursday. VillageMD is […]
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