CMS Takes Aim At Prior Authorization Requirements In Medicare Advantage

The Centers for Medicare & Medicaid Services (CMS) is proposing new limits on Medicare Advantage (MA) plans regarding prior authorization, utilization management, coverage decisions and the use of artificial intelligence (AI). These proposed changes aim to address the barriers to accessing care identified by CMS. Data reported to CMS by MA plans show that, on […]

Home Health Leaders On Leaders: 4 C-Suite Execs That Are Driving The Industry Forward

The most compelling and innovative leaders in home health care don’t just inspire the people who work at their companies, they also catch the attention of fellow industry leaders. These leaders have earned the high esteem of their peers by hurdling operation challenges in the space, creating impressive recruitment initiatives, consistently embracing new ideas and […]

2024 Executive Forecast: What 6 Top Home Health Leaders Expect Next Year

Staffing shortages, rate cuts and Medicare Advantage penetration will continue to be trends in the home health market in 2024. Those aren’t new. What is new, however, is how providers plan to combat the issues that stem from those trends. Home health leaders are focused on mitigating margin compression, utilizing more technology, leveraging artificial intelligence, […]

Blue Cross Blue Shield Of Massachusetts To Eliminate Prior Authorization For Home Health Discharges

Blue Cross Blue Shield of Massachusetts is getting rid of one of the biggest pain points for home health providers: prior authorization. The change will eliminate more than 14,000 authorizations, according to the company. Broadly, patients being discharged from the hospital to home health care will not need advanced approval. The types of care that […]

Home-Based Care Providers Still Waiting for Payer Equity

Home-based care has taken on a more prominent role in the broader health care continuum, but there are still challenges bubbling underneath the surface. One of these challenges is a lack of payer equity, John Kunysz, president and CEO of Intrepid USA Healthcare Services, said last month at Home Health Care News’ Capital+Strategy conference. “I […]

Payer Influence Growing in Home-Based Care

Another in-person event came and went this week, as Home Health Care News hosted its annual Capital+Strategy event in Arlington, Virginia. And as executives, analysts, private equity representatives and others gathered to discuss the state of home-based care, news dropped that UnitedHealth Group (NYSE: UNH) is acquiring LHC Group Inc. (Nasdaq: LHCG) and combining the […]

Why Post-Acute Care Is Health Care’s New ‘Apex Predator’

A large post-acute care company with a deep presence in America’s rural areas, Intrepid USA Healthcare Services has been in the market for a new private equity partner. Intrepid is a Texas-based provider of home health, hospice and personal care services. The company has more than 60 locations spanning 17 states. CEO John Kunysz likes […]