Home Health Agencies Still Waiting for Details After Feds Float Plans to Distribute Point-of-Care COVID-19 Tests

Although the concrete details are unknown, the federal government appears to be taking steps toward distributing point-of-care COVID-19 diagnostic tests to home health agencies, which have largely been prioritized behind skilled nursing facilities (SNFs) and other congregate aging services providers. The U.S. Department of Health and Human Services (HHS) announced on Aug. 27 that it […]

CMS Completes Home Health Compare Overhaul, Launches New Medicare Tool

Nine months after initially floating the idea, the U.S. Centers for Medicare & Medicaid Services (CMS) has launched Care Compare, a consumer-facing database of provider quality information. The agency announced the launch on Thursday. CMS originally announced its plan to merge Home Health Compare with the seven other Compare sites in January. Agency officials said […]

More Than Half of All Home Health Agencies Have Treated COVID-19 Patients

The U.S. Centers for Medicare & Medicaid Services (CMS) officially closed its public comment window for the 2021 proposed home health payment rule on Monday. Unlike the past couple of years, the latest proposed payment rule included relatively minor changes and rate adjustments for the year ahead. In light of the mild proposal, CMS only […]

CMS Announces New ‘Phased-In Approach’ to the Review Choice Demonstration

The U.S. Centers for Medicare & Medicaid Services (CMS) announced Friday it will not resume a full-blown resumption of the Review Choice Demonstration (RCD) for home health agencies in participating states later this month. Instead, CMS is “phasing in” RCD for agencies in North Carolina and Florida. Agencies in Illinois, Ohio and Texas will be […]

Home Health Agencies Aren’t ‘Upcoding’ to Maximize PDGM Reimbursement

In designing the Patient-Driven Groupings Model (PDGM), officials from the U.S. Centers for Medicare & Medicaid Services (CMS) made a handful of assumptions about how Medicare-certified home health operators would respond once the overhaul went live. Among those assumptions, CMS believed home health agencies would automatically “upcode,” or pick the primary diagnosis code tied to […]

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 […]