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 […]

CMS Finding New Ways to Penalize Home Health Providers

The Centers for Medicare & Medicaid Services (CMS) is finding new ways to penalize home health providers. In its proposed payment rule for 2020 released last week, CMS floated the idea of phasing out pre-payments for home health services starting in 2020, killing them completely by the following year. Currently, home health providers can receive […]

Beating the Buzzer: Why Timing Is Everything Under PDGM

While timing tweaks haven’t received quite the attention therapy and coding changes have ahead of the Patient-Driven Groupings Model (PDGM), beating the buzzer will be more important than ever for home health agencies when the new model takes effect. For example, the Centers for Medicare & Medicaid Services (CMS) will pay higher reimbursement rates for […]

Creative PDGM Therapy Strategies for Home Health Agencies

When the Patient-Driven Groupings Model (PDGM) takes effect on Jan. 1, 2020, therapy-heavy home health agencies will have to get creative to ensure the new model doesn’t hurt their bottom line. PDGM eliminates therapy-visit volume as a determining factor in calculating reimbursements, meaning therapy will no longer be a guaranteed revenue-driver for home health agencies. […]

Credit, Billing Staff Are Keys to a Smooth Financial Transition into PDGM

When the Patient-Driven Groupings Model (PDGM) takes effect Jan. 1, home health care billing processes will become significantly more complicated. The new model revolutionizes the way agencies are reimbursed, cutting payment periods in half and requiring more detailed claims, among other changes. As a result, PDGM will likely put financial strain on even the most […]