As home health patients become sicker and more complex, providers have been forced to find ways to keep their care models financially viable. In order to combat some of those “acuity creep” challenges, industry leaders are leaning on technology, data-driven decision making and more value-based care. “We continue to navigate through a very regulated industry,” […]
Following the implementation of the Patient-Driven Groupings Model (PDGM) – and during the height of the COVID-19 pandemic – home health providers struggled significantly with Low-Utilization Payment Adjustments (LUPAs). Since then, some providers have found ways to mitigate them, and others haven’t. Broadly, LUPAs occur in fee-for-service Medicare when a provider does not meet a […]
Getting to the negotiating table with Medicare Advantage (MA) plans and coming away with a good deal is tough enough for even the biggest players in home health care. For smaller providers, it’s an even more daunting and intimidating task. However, there are steps those smaller providers can take in order to become more attractive […]
Although home health providers want to see as many patients as possible to keep up with demand, it is impossible to do so under current circumstances. With that in mind, providers are questioning why they would willingly take on Medicare Advantage (MA) beneficiaries knowing they’d be sacrificing dollars. Some industry experts believe providers should, at […]
Back in October, Hospice and Home Care of Juneau closed after 20 years in business. A month earlier, Trinity Health At Home in Springfield, Illinois, shut its doors and laid off 60 employees. At the start of the new year, Oahu Home Healthcare announced it was shutting down, leaving just eight at-home care agencies on […]
The home health industry at large is excited about the prospects of the Choose Home Care Act of 2021. For now, it’s been tabled in Washington, D.C., due to a variety of reasons, including it being an election year. It’s also – to some extent – been cast aside in home health providers’ minds, given […]
Certificate of Need (CON) laws for home health agencies vary by state. In some states, there are no restrictions. In others, there are strict restrictions on how many home health and hospice providers are allowed to operate. There are also ones with CON laws in hospice, and not in home health – or vice versa. […]
The switch to the Patient-Driven Groupings Model (PDGM) was always going to be a hurdle for home health agencies, but the onset of the COVID-19 crisis has exacerbated the woes associated with it. For instance, managing 30-day billing periods and avoiding low-utilization payment adjustments (LUPAs) have been pain points for providers across the country over […]
The historic wave of consolidation that home health M&A experts predicted ahead of the Patient-Driven Grouping Model (PDGM) hasn’t fully panned out, largely due to the COVID-19 emergency and the billions in federal relief dollars that have come with it. There was some degree of contraction within the industry, however. Going into 2020, there was […]
The U.S. Centers for Medicare & Medicaid Services (CMS) issued its final 2021 home health payment rule in late October. When it came out, some providers were less than pleased. On one hand, the Patient-Driven Groupings Model (PDGM) wasn’t substantially altered to balance out its flawed behavioral assumptions. On another, there are also a few […]
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