OIG: CMS Could Have Saved $192M with Stronger LUPA Oversight

Federal watchdogs are once again setting their sights on perceived improper billing practices by home health agencies. In an audit report published last week, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) found that stronger oversight of Low Utilization Payment Adjustments (LUPAs) in home health care could have saved […]

The Number of Medicare-Certified Home Health Agencies Is Dwindling

The number of Medicare-certified home health agencies in the United States is dwindling — and it’s a trend that started long before the Patient-Driven Groupings Model (PDGM) kicked in. From 2018 to 2019, the number of home health agencies dropped by about 3.6%, a decrease of 427 individual providers, according the Medicare Payment Advisory Commission […]

Time for Policymakers, Hospitals to Bet Big on Home-Based Care

It’s time for policymakers, hospitals and everyone else at the health care roulette table to bet all their chips on proactive, pre-acute home-based care. During the coronavirus pandemic, the U.S. health care system has undergone a massive change marked by the skyrocketing use of telehealth technology and the shift away from brick-and-mortar medical appointments. In […]

Tale of Two Home Health Providers: ‘Value-Based Care Gap’ Growing Wider

Earlier in June, the Trump administration and the U.S. Centers for Medicare & Medicaid Services (CMS) touted a “renewed national commitment to value-based care.” But for that renewed commitment to take off in the home health care space, government officials need to act fast, industry insiders caution. There’s a widening value-based care gap between larger […]

CMS Appoints New Chief Medical Officer

The U.S. Centers for Medicare & Medicaid Services (CMS) announced a number of new leadership appointments on Tuesday. The agency’s leadership shakeup includes naming a new chief medical officer, a role that had been vacant since Dr. Kate Goodrich joined Humana Inc. (NYSE: HUM) in March. Dr. Lee Fleisher will take over as CMS’s CMO […]

Rural Markets May Offer Huge Upside for Home Care Providers Looking to Break into Medicare Advantage

Many home care providers jumped at the chance to create new Medicare Advantage (MA) business lines after the U.S. Centers for Medicare & Medicaid Services (CMS) began making supplemental benefits more flexible more than two years ago. Now, those same providers that got into MA early are beginning to better understand the space while hunting […]

Coronavirus Daily Update: PQHH Sends New Letter to CMS; LeadingAge Responds to Trump’s Testing Statement

During this critical time, Home Health Care News remains committed to bringing you all the essential news related to home-based care operations. At the same time, we also recognize the seriousness of the COVID-19 pandemic. In addition to our regular content, we’ll continue to highlight industry-related developments and mitigation strategies in this rolling bulletin. What […]

‘Nothing Is Recession-Proof’: What an Economic Downturn Means for Home-Based Care Providers

While the U.S. economy has sunk into its first official recession since 2008, home-based care experts are largely confident in the industry’s ability to withstand emerging economic hardships. In fact, “recession-proof” is the term many often use. Soaring demand, an evolving payment landscape and shifting consumer demographics may protect home-based care providers from too much […]