Home-Based Care Wins Included In The $1.66T Omnibus Spending Bill

Home-based care providers are enthused – at least in part – by the passing of the $1.66 trillion omnibus spending bill in December. Specifically, they’re bullish on the added transparency language required from the Centers for Medicare & Medicaid Services (CMS), a two-year extension for Medicare telehealth provisions and further value-based care incentives. “CMS being […]

How Coding Could Change Under The Home Health Proposed Payment Rule

As home health providers wait for the finalized version of the proposed payment rate rule, it’s important to get familiar with the coding changes the proposal makes, and how it will directly impact Patient-Driven Groupings Model (PDGM) calculations. When coding, the primary diagnosis of the patient should be driven by the primary focus of care […]

‘It’s Just Wrong on Every Level’: Home Health Insiders Object to Review Choice Demonstration Details

The rollout of the U.S. Centers for Medicare & Medicaid Services’ (CMS) Review Choice Demonstration (RCD) has been anything but smooth. The initiative implemented to reduce improper billing and fraud in select states has been plagued by issues like COVID-19-related delays and missteps by CMS and its contractors, among others. Despite the flaws, the demo […]

Back-End Problems Continue to Haunt Home Health Agencies

Managing back-end operations is arguably as paramount to a home health agency’s success as the patient-facing, clinical aspects of the business. Even so, that task has often been put on the back-burner in the past. But with the onset of no-pay RAPs, the Patient-Driven Groupings Model (PDGM), the Review Choice Demonstration (RCD) in select states […]

Home Health Agencies Plan Ahead for Full-Blown RCD Resumption

Earlier this month, the U.S. Centers for Medicare & Medicaid Services (CMS) announced it will not immediately pursue a full-blown restart of the Review Choice Demonstration (RCD), a regulatory initiative designed to reduce improper billing in home health care. Instead, CMS outlined how it will move forward with a “phased-in approach” to RCD that gives […]

Accelerated Payments from CMS Can Help Medicare Providers Stay Afloat, But Come with Potential Dangers

Advanced payments from the U.S. Centers for Medicare & Medicaid Services (CMS) can help home health agencies navigate cash flow challenges associated with the COVID-19 virus. But providers will need to approach accelerated payments with caution, armed with accurate, objective assessments of their internal financial situations. During times of natural disasters, CMS normally offers expedited […]

Tech-Powered Therapy Provider Nets $9M, Targets Home Health Industry Amid PDGM Disruption

Home health providers struggling with the delivery of therapy services may soon have increased access to an up-and-coming telerehab tool that’s promising to disrupt the traditional physical therapy model. Sword Health, a tech-enabled physical therapy provider, announced that it has received $9 million more in funding for its Series A round. The additional funds bring […]

Where PDGM’s Therapy Changes Will Hit Hardest

By eliminating visit-volume thresholds and tying reimbursement more closely to need, the Patient-Driven Groupings Model (PDGM) will likely steer the home health care industry away from therapy and toward nursing. Although PDGM officially starts on Jan. 1, home health providers have already begun to shift their therapy utilization strategies to better line up with the […]

Home Health Value-Based Purchasing Model Likely Headed to the Scrap Yard

The Home Health Value-Based Purchasing Model (HHVBPM) is likely headed for the scrap yard in the not-too-distant future. Implemented in 2016, HHVBPM was generally designed to pay home health providers in nine states based on outcomes and the value of services delivered. While many thought HHVBPM was fated for expansion, the initiative appears to be […]

Counterpoint: Elimination of RAPs Isn’t a ‘Sky-Is-Falling Issue’

Since the Centers for Medicare & Medicaid Services (CMS) announced its proposal to phase out Requests for Anticipated Payments (RAPs) last month, home health providers have voiced their concerns about what the change will mean for them. Industry-wide, the consensus isn’t good. Many providers worry the removal of RAPs, in addition to the other regulatory […]