Chronic Conditions Cost US Economy More Than $4.5 Trillion

The overall economic burden associated with diabetes, heart disease, dementia and other chronic medical conditions in the United States now adds up to more than $4.5 trillion, a new report has found. While already staggering, that economic burden is projected to double within the next three decades as well, propelled by the wave of aging […]

Senator Rand Paul Slams PDGM, ‘Guesses by Government Bureaucrats’

House lawmakers have yet to introduce a companion bill to the Home Health Payment Innovation Act (S. 433), legislation introduced in the Senate in February focused on the Patient-Driven Groupings Model (PDGM). That doesn’t mean the home health industry has lost the attention of Congress when it comes to PDGM and future payment, however. Kentucky […]

Letter to the Editor: Amedisys CEO Paul Kusserow Pushes Back on Improper Payment Reports

Your article, “CMS Made $3.2 Billion in Improper Home Health Payments in 2018,” deserves a headline that draws readers’ attention to the real story here. Only in the next-to-last sentence does the piece mention the most telling data point — namely, that improper home health payments “plummeted dramatically” between 2015 and 2018 from 59% of […]

Home Care Providers Look Ahead as Medicare Advantage Evolution Continues

Home care providers slow to chase Medicare Advantage business opportunities may now be motivated to speed up their pursuits. Last week, the Centers for Medicare & Medicaid Services (CMS) announced it was broadening the range of supplemental benefits Medicare Advantage (MA) plans can offer in 2020. Starting next year, health care policymakers will allow MA […]

CMS Finalizes In-Home Medicare Advantage Telehealth Policies

The Centers for Medicare & Medicaid Services (CMS) announced Friday that the agency has finalized a set of policies designed to expand the use of telehealth benefits under the Medicare Advantage program. Originally proposed in October 2018 for the 2020 plan year, the new policies from CMS are meant to expand access to telehealth services […]

CMS Picks Review Choice Demo Start Date, Releases New Details

The Centers for Medicare & Medicaid Services (CMS) has picked an official start date for its Review Choice Demonstration (RCD), an initiative meant to curb improper billing among home health providers. On Wednesday, CMS announced RCD will begin in Illinois on June 1. For home health providers operating in Illinois, that means all episodes of […]

CMS Launches AI Challenges for Predicting Unplanned Hospital, SNF Admissions 

The Centers for Medicare & Medicaid Services announced last week the launch of a three-stage challenge designed to encourage the use of artificial intelligence (AI) in health care. As part of the challenge, participants will be tasked with using AI to better predict unplanned hospital and skilled nursing facility admissions — already a key focus […]

CMS Made $3.2 Billion in Improper Home Health Payments in 2018

Despite increased oversight efforts, improper payments under Medicare and Medicaid are costing the federal government billions of dollars, a new report from the watchdog arm of Congress has found. And home health providers appear to be the root of the problem. In fiscal year 2018, improper Medicare fee-for-service (FFS) payments totaled $31.6 billion for all […]

Senator Susan Collins Takes Aim at PDGM’s Behavioral Assumptions

Home health providers and advocates have carefully worked to cultivate their political clout on Capitol Hill over the past few decades. Those efforts — paired with changing U.S. demographics, proven savings to the U.S. health care system and older adults overwhelmingly expressing their desire to age in place — have helped win the support of […]

Review Choice Demonstration Clears Hurdle, Likely Starting Soon

The Review Choice Demonstration (RCD) is likely right around the corner for Illinois home health providers. The Centers for Medicare & Medicaid Services (CMS) announced March 4 it had received Paperwork Reduction Act approval for RCD from the White House Office of Management and Budget (OMB). Since OMB approval, the agency has been finalizing the […]