Last week, Sen. Susan Collins (R-Maine) introduced a bill that would reset the home health base payment rate and give the Centers for Medicare & Medicaid Services (CMS) new fraud-fighting tools. The bill serves as a microcosm of how lawmakers appear to view the home health industry: with equal parts support and suspicion. It’s a […]
Sen. Susan Collins (R-Maine) has introduced a bill that, if enacted, would give the Centers for Medicare & Medicaid Services (CMS) additional tools to prevent and detect home health fraud and reset the Medicare home health payment rate to levels seen before years of payment cuts. The bill, called the Medicare Home Health Payment Integrity […]
The Centers for Medicare & Medicaid Services (CMS) has expanded the Comprehensive Care for Joint Replacement (CJR) Model, which aims to encourage collaboration among health care entities — including home health providers. Most hospitals will be required to participate in the CJR Expanded (CJR-X) model beginning in January 2028. “CJR-X gives more patients the opportunity […]
When I started covering home-based care, I did not anticipate that the industry would become a flashpoint in partisan politics, beyond familiar debates about reimbursement rates and the finer points of regulations. So, I’ve been surprised — and disturbed — by developments this year. The latest came this week: the U.S. Centers for Medicare & […]
On Tuesday, the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) announced that the agencies deferred over $1 billion in Medicaid payments for certain high-risk Medicaid claims in two states, including home-based services. HHS and CMS deferred $867.5 million in federal Medicaid payments to California and […]
The Centers for Medicare and Medicaid Services (CMS) has issued updated survey guidance on home health agencies’ acceptance-to-service policies, a new standard under the Home Health Agency Conditions of Participation that took effect in Jan. 2025. The agency issued the guidance to home health agencies in a Wednesday memo, clarifying requirements to develop, implement and […]
Home-based care providers have an unmatched view of barriers that can undermine care outcomes known as social determinants of health. Even without an immediate financial incentive, some home-based care providers are addressing these social determinants of health to remove these obstacles — and to give frontline workers a better chance to deliver the services patients need. “Home healthcare […]
UnitedHealth Group’s (NYSE: UNH) in-home health program, HouseCalls, coincided with up to 5% fewer inpatient stays and 4% fewer emergency room visits for older adults with conditions such as diabetes and hypertension in the year after their visit, according to a Tuesday announcement. In the announcement, the healthcare giant shared initial results of an external […]
The Centers for Medicare and Medicaid (CMS) has experimented with pre-claim review processes — and new research suggests that this Medicare program can be highly effective, but only in certain states. Medicare pre-claim reviews for home health services cut spending in Illinois by 13% and reduced an estimated $1.2 billion in traditional Medicare home health […]
National home health care spending continues to grow in 2026, though at a slower rate than in recent years, according to a new report from the Centers for Medicare and Medicaid Services (CMS) published in Health Affairs. Annual growth for home health care is projected to decrease from about 10.3% in 2025 to 7.9% in […]
