The Centers for Medicare & Medicaid Services (CMS) announced a 5.06% Medicare Advantage payment increase on Friday – more than double the rate suggested by the outgoing Biden administration. The final rule is largely positive news for the home-based care community, Fred Bentley, managing director in ATI Advisory’s care continuum strategy and solutions practice, told […]
ATI Advisory
The forthcoming TEAM bundled payment model will offer home health providers opportunities to boost utilization and develop stronger referral partnerships – if they understand and succeed in their roles within a 30-day episode of care. The Transforming Episode Accountability Model (TEAM), set to begin on Jan. 1, 2026, requires providers to “front-load” the episode of […]
In-home care has long been considered a key component in ensuring optimal recovery from knee replacements, but self-care appears to be as effective for many patients. Patients who receive home-based care following a total knee arthroplasty do not uniformly report better outcomes than those who recover via self-care at home, according to a study from […]
The landscape of home health care is evolving through the introduction of two key models designed to improve patient outcomes and reduce costs: the expanded Home Health Value-Based Purchasing (HHVBP) model and the Targeted Episode-Based Medicare Access and Payment (TEAM) model. These initiatives incentivize home health agencies to provide high-quality, coordinated care while addressing the […]
While getting a fair rate is top of mind for home health providers, the ones that are seeing the most success in their negotiations with Medicare Advantage (MA) payers are selling their ability to be a solution. Even before entering negotiations with MA plans, providers should have a clear understanding of the challenging reimbursement environment […]
With the need for long-term services and supports (LTSS) growing, Medicare Advantage (MA) plans are positioned to offer home-based care services through supplemental benefits. That’s one key takeaway from a new data brief from the research and advisory firm ATI Advisory, though MA plans haven’t always been the best administrators of home care. The report […]
The United States relies heavily on family caregivers, so much so that the Biden administration has gone lengths to support them. Still, in order for family caregivers to actually reduce the cost of care in the home, they need to be given the proper resources and education. Otherwise, patients are likely receiving – unbeknownst to […]
During the pandemic, some senior care models succeeded, and some didn’t. The Program of All-Inclusive Care for the Elderly (PACE) was one that did. In 2023, PACE enrollment exceeded 70,000 participants and has seen an over 40% growth in enrollment since 2019. Many home-based care providers have already gotten into PACE. The Jacksonville-based Alivia Care […]
Around 2019, Medicare Advantage (MA) was all the rave among home care providers. That’s because, in 2018 and 2019, two pathways opened for MA plans to provide more benefits to beneficiaries: the primarily health-related benefit pathway and the Special Supplemental Benefits for the Chronically Ill (SSBCI) pathway. Included in those were plenty of areas of […]
Generally, home health agencies have expressed dissatisfaction with payment rates and reimbursement policies set by managed care companies. Negotiations around rates can often be contentious. In 2024, however, providers can win with the correct focuses in mind. “You don’t want a managed care strategy; you want a value-based care strategy,” Anne Tumlinson, founder and CEO […]
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