What CMS Gets Wrong About Referral Rejection Rates In Home Health Care

In light of the increasing need for post-acute care, hospitals are grappling with challenges tied to ensuring patients are directed to the most suitable post-discharge care setting. While referral volume to home health agencies continues to be higher than pre-pandemic levels, rejection rates continue to be a major pain point for providers. Home health agencies […]

Certain HHVBP Measures Remain Disconnected From On-The-Ground Home Health Care Delivery

The Home Health Value-Based Purchasing (HHVBP) Model is one of the Center for Medicare and Medicaid Innovation’s (CMMI) only cost-saving successes, which is why it was expanded nationwide on Jan. 1, 2023. Just six of 49 CMMI payment demonstrations have produced savings, with HHVBP standing out in a major way. HHVBP is expected to save […]

Home Health Agencies Made The HHVBP Model Demonstration A Resounding Success

In the first six years of the Home Health Value‐Based Purchasing (HHVBP) Model demonstration, the nine participating states saved Medicare $1.38 billion, a 1.9% decline relative to the 41 non‐HHVBP states. That’s according to a new study from the U.S. Centers for Medicare & Medicaid Services (CMS) that evaluated the first six years of HHVBP […]

How Home-Based Care Helped The Medicare Shared Savings Program Generate $1.8B In Savings

The Medicare Shared Savings Program (MSSP) continues to save Medicare over a billion dollars annually. And some of the highest-performing, most innovative Accountable Care Organizations (ACOs) participating in the program continue to generate savings by effectively using home-based care. The U.S. Centers for Medicare & Medicaid Services (CMS) announced Thursday that MSSP saved Medicare $1.8 […]

Lawsuit Filed Against HHS Over Home Health Care Shortcomings Dismissed

The U.S. District Court for the District of Columbia has dismissed a class action lawsuit that accused the U.S. Department of Health and Human Services (HHS) of failing to properly administer the Medicare home health benefit. The plaintiffs had argued the home health services required under Medicare law were wholly insufficient. Medicare law authorizes coverage […]

Government Watchdog Agency Signs Off On CMS Home Health Final Payment Rule

The U.S. Government Accountability Office (GAO) has signed off on the home health payment rule finalized by the Centers for Medicare & Medicaid Services (CMS) last month. After its review, the GAO found that CMS appropriately determined the impact of the difference between assumed versus actual behavior change on estimated aggregate expenditures for home health […]