Recent developments in the legal battle over the planned $3.3 billion UnitedHealth Group (NYSE: UHG) acquisition of Amedisys (Nasdaq: AMED) have moved the case closer to trial and shed more light on how UnitedHealth and Amedisys are pursuing divestments and defending the transaction. First, UnitedHealth dropped its motion to dismiss the case, saying that the […]
CMS
The Comprehensive Care for Joint Replacement (CJR) model has had a modestly positive effect on how often joint replacement patients receive home health care, but “sizeable portions” of these patients still “miss out” on such services. This is according to study findings recently published in the American Journal of Managed Care. To enhance care coordination […]
End-of-life home health care use and duration are lower among Medicare Advantage (MA) enrollees compared to traditional Medicare enrollees across nearly all populations. This is especially true among Hispanic people and people identifying as Asian or Pacific Islander, according to a research letter published in the Journal of the American Medical Association. Researchers found that […]
The Trump administration has instructed federal health agencies to pause all external communications, including health advisories, weekly scientific reports, updates to websites and social media posts, according to reports by CNN and the Washington Post. These orders were conveyed on Jan. 21 to staff at agencies within the U.S. Department of Health and Human Services […]
In response to hospital capacity challenges brought on by the COVID-19 pandemic, the Centers for Medicare & Medicaid Services (CMS) collaborated with external experts to create the Acute Hospital Care at Home (AHCAH) initiative. This initiative will expire on Dec. 31 unless Congress extends it. After three years of implementation, early insights regarding quality, costs […]
Living in an urban area typically offers greater access to a wider range of home care services than living in a rural area. Urban residents generally have more choices regarding providers and facilities, while those in rural areas face challenges such as longer travel distances, limited provider availability and potential concerns about the quality of […]
Research has indicated that patients needing care prefer to receive it in their homes rather than in a hospital setting. Health care models like Hospital at Home (HaH) facilitate this preference, but how do providers ensure that patients’ homes are safe for delivering these services? For this evolution to be successful, homes must adapt. They […]
The Centers for Medicare & Medicaid Services (CMS) is proposing new limits on Medicare Advantage (MA) plans regarding prior authorization, utilization management, coverage decisions and the use of artificial intelligence (AI). These proposed changes aim to address the barriers to accessing care identified by CMS. Data reported to CMS by MA plans show that, on […]
Home health providers may walk away from specific health plans due to financial feasibility, administrative burdens, or misalignment with their patient care values and priorities. However, this decision can create short-term challenges with referral partners and health systems, as they may have patients enrolled in those plans. “If a health plan consistently under-reimburses for services […]
Medicare Advantage (MA) companies have faced an unfavorable rate and regulatory environment over the last couple of years. That has given home health providers hope that MA penetration may cool off. It also has given them a bit more leverage in negotiations. Plans will see a 0.16% decrease to core payments in 2025, a second-straight […]