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 […]

Fair Scheduling Trend Could Spell Trouble for At-Home Care Providers

In recent years and months, rising minimum wage has been top of mind for home-based care providers, adding another level of difficulty to attracting and retaining workers. But fair scheduling legislation that’s gaining steam in cities and states across the country could soon take center stage — and potentially make matters worse. Fair scheduling legislation […]

Home Health’s Main Appeal to Assisted Living Facilities

Although it’s often delivered in the private residences of older adults, home health care can also offer several benefits to assisted living providers, especially as their residents become older and more medically complex. In fact, by leveraging home health services, assisted living operators may be able to keep residents in their facilities longer. That’s according […]

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 […]

Primary Diagnosis Changes Among PDGM’s Most Overlooked Aspects

The Patient-Driven Groupings Model (PDGM) is just nine months from taking the home health care industry by storm. By now, operators should have started preparing for the sweeping adjustments on tap for 2020 — but taking the right steps at the right time is crucial to ensuring success. Among its high-level changes, PDGM removes perceived […]

NAHC’s Dombi: PDGM Discriminates Against Community Referrals, RCD Could Haunt Home Health Providers

With a slew of regulatory and legislative changes on the horizon — from the Patient-Driven Grouping Model (PDGM) to the Review Choice Demonstration (RCD) — the home-based care industry is poised for massive transformation. Despite federal challenges, the industry’s outlook is more promising than ever, advocates believe. “The image that you have is so, so […]

Home-Based Care Industry Reacts As Illinois Raises Minimum Wage

Illinois has joined a number of states set to raise their minimum wage dramatically in the years to come. Gov. J.B. Pritzker (D-Ill.) on Tuesday signed a law raising minimum wage to $15 an hour by 2025. The move has drawn praise from caregiver advocates and criticism from industry leaders — who worry home health […]

CMS Lifts Moratoria on Home Health After 5 Years

The long-standing moratoria on new Medicare home health agencies is no longer in effect anywhere in the U.S. The Centers for Medicare & Medicaid Services (CMS) allowed the temporary ban to expire on Jan. 30, a move that will likely improve patient access to home-based care in related markets, experts say. CMS initially implemented a […]

CMS Fails to Start Home Health Review Choice Demo as Scheduled

The Centers for Medicare & Medicaid Services (CMS) did not meet its publicly announced Monday goal of launching the Review Choice Demonstration (RCD) in Illinois. RCD is a revamped version of CMS’ widely opposed Pre-Claim Review Demonstration (PCRD) from 2016, an initiative that required home health providers to send in their Medicare claims earlier in […]