Pause to Alternative Payment Models Gives Some Providers a ‘Golden Ticket,’ Leaves Others Behind

The Global and Professional Direct Contracting Model — a Center for Medicare & Medicaid Innovation (CMMI) creation — has been put on pause. The holdup is just another example of CMMI pumping the brakes on an alternative payment model in the days since the Biden administration took over the executive branch.   Broadly, the Global and […]

Not a ‘Temporary Blip’: Home Health Agencies Gaining Greater Share of Hospital Discharges

The anecdotal claims from home health insiders were true: Across the country, home health agencies gained a greater share of discharges from short-term acute care hospitals during the public health emergency. Specifically, the percentage of patients discharged into home health care rose 1.8% from March to May of 2020, from 17% to 18.8%. That would […]

Number of MA Plans Offering SSBCI ‘Social Needs Benefit’ Up 568% in 2021

In September, the U.S. Centers for Medicare & Medicaid Services (CMS) released high-level data suggesting a huge expansion of new Medicare Advantage (MA) supplemental benefits for 2021. CMS followed that up with specific information on MA supplemental benefits under the “primarily health-related” pathway a month later, catching home care providers’ attention due to strong numbers […]

New Data Confirms More Patients Are Being Discharged to Home Health Agencies

Patients discharged from hospitals are increasingly headed to home health agencies, a new analysis from ATI Advisory shows. In May 2019, of the 801,464 patients discharged from short-term acute care hospitals (STACHs), 11% were sent to home health agencies. In May 2020, of the 558,296 patients discharged from STACHs, 19% went to home health agencies. […]

UnitedHealthcare Advances Home Strategy, Expects to Make 1.7M House Calls in 2020

A number of major Medicare Advantage (MA) carriers are expanding their supplemental benefit offerings shaped around in-home care next year. UnitedHealthcare, the insurance arm of UnitedHealth Group (NYSE: UNH), is among them. Overall, UnitedHealthcare partners with more than 1.3 million physicians and care professionals across the U.S., plus another 6,500 or so hospitals and other […]

States with the Most ‘Primarily Health-Related’ Medicare Advantage Opportunities for Home Care Agencies

With hundreds of plans reportedly offering in-home support services in 2021, the coming year is certain to bring more Medicare Advantage (MA) opportunities for home care agencies. But some home care operators will have more opportunities than others due to geographic variability across the MA landscape. To find leads, agency leaders will need to understand […]

Number of MA Plans Offering In-Home Support Services to Increase by 93% in 2021

The U.S. Centers for Medicare & Medicaid Services (CMS) last month released new Medicare Advantage (MA) figures highlighting a massive expansion of plans offering home-focused supplemental benefits in 2021. The agency shared additional data on Wednesday — and it now appears the ongoing home care MA movement is even bigger than originally anticipated. “These benefit […]

As In-Home Care Providers Embrace Medicare Advantage, They’ll Need to Better Manage Vulnerable Populations

For years now, the U.S. health care system has steadily moved away from a fee-for-service environment toward value-based care. Medicare Advantage (MA) growth reflects this shift, particularly when it comes to the wide spectrum of home-based care. Currently, the average home health agency gets about 55% of its funding from fee-for-service Medicare, Medicare Payment Advisory […]

Disrupt Podcast #33: Anne Tumlinson, CEO of ATI Advisory

The 33rd episode of our podcast, Disrupt, is now available! Home care agencies nationwide are eager to partner with Medicare Advantage plans, but doing so is easier said than done. However, mid-year flexibilities recently announced by CMS instantly opened up new opportunities for providers. In this episode of Disrupt, you’ll hear from Anne Tumlinson, CEO […]