Despite initial challenges, 2025 appears promising for home health providers, as indicated by industry experts in Home Health Care News’s recent webinar, Home Health Outlook 2025. During the discussion, experts addressed several key issues, including Medicare Advantage (MA) reimbursement rates, labor shortages and improved technology integration. The panel also explored future risk-sharing opportunities and highlighted […]
Medicare Advantage
Home-based care providers hungry for value-based care arrangements have recently been disillusioned by the process of trying to find those arrangements. While they’ve been told value-based care is the way to go, they often end up finding that health systems and payers aren’t as willing to meet them in the middle. Enhabit Inc. (NYSE: EHAB) […]
A new analysis by the Kaiser Family Foundation (KFF) reveals that Medicare spending is higher for beneficiaries who switch from Medicare Advantage (MA) to traditional Medicare compared to similar beneficiaries who have continuously been enrolled in traditional Medicare. These beneficiaries cost Medicare an average of 27% more, according to the analysis, which examined health costs […]
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 providers may walk away from specific health plans due to financial feasibility, administrative burdens, or misalignment with their patient care values and priorities. However, this decision can create short-term challenges with referral partners and health systems, as they may have patients enrolled in those plans. “If a health plan consistently under-reimburses for services […]
Essentia Health has reached an agreement with UnitedHealthcare (UHC) to remain an in-network provider for UHC’s Medicare Advantage insurance plan in 2025. Earlier this year, Essentia announced plans to discontinue its status as an in-network provider for UHC and Humana Inc. (NYSE: HUM) Medicare Advantage insurance plans due to reported issues with denials of payment […]
Medicare Advantage (MA) companies receive higher risk-adjusted payments from the Centers for Medicare & Medicaid Services (CMS) for sicker enrollees. This helps ensure that plans receive sufficient payments to cover increased care costs and that enrollees have access to plans. However, a new report states that taxpayers are footing the bill for billions of dollars […]
The Senate Homeland Security Permanent Subcommittee on Investigations (PSI) released a report on Thursday revealing that the nation’s three largest Medicare Advantage (MA) insurers have significantly increased the rate at which they denied seniors’ post-acute care from 2020 to 2023. This includes denying access to nursing homes, inpatient rehabilitation facilities and long-term acute care hospitals. […]
Hospital at Home (HaH) is a sustainable, innovative and next-generation health care model. From the physician’s perspective, it offers person-centered medical care and keeps patients out of the hospital, away from possible complications and on to better outcomes. However, there are still plenty of challenges for providers to work through. “People love to have inpatient […]
The Helper Bees has introduced a flexible benefit card called helpful, which grants access to over-the-counter (OTC) products, groceries and a nationwide network of vetted Social Determinants of Health (SDoH) providers through a unified card experience. Helper Bees, based in Austin, Texas, is the developer of an aging-in-place platform that connects families with services in […]
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