MedPAC Says Home Health Margins Too High, Fraud Rampant

Integrity remains at the heart of ongoing discussions about home health care reimbursements, and rampant fraud could be cause for further payment cuts. With overpayments remaining high across the home health industry, more payment reductions are called for, as rebasing attempts to bring reimbursement rates in line with costs, members of the Medicare Payment Advisory […]

ACOs Branch Out to Medicaid with New Dual-Eligible Model

A new type of accountable care organization (ACO) is in the works for beneficiaries who account for a disproportionate share of home health spending, the Centers for Medicare & Medicaid Services (CMS) announced. The model may help pay for some of the sickest—and most costly—patients in coordinated care models. Dual-eligible beneficiaries qualify for both Medicare […]

Industry Groups Critique Home Health Reimbursement Changes

More home health payment cuts are coming, and home health care groups are fighting back against further proposals to change reimbursement measures. Most recently, industry groups shot back against the Home Health Prospective Payment System Rate Update for calendar year 2017, which had an open public comment period that ended August 26. In conjunction with […]

MedPAC Recommends Deeper Home Health Payment Cuts

The $180 million reduction in CY2017 Medicare home health payments proposed by the Centers for Medicare & Medicaid Services (CMS) isn’t enough and should go further, the Medicare Payment Advisory Commission (MedPAC) wrote in a letter to CMS. The proposed changes to the Medicare home health prospective payment system (HH PPS), which were posted on […]

Editor’s Picks: The Older Americans Reauthorization Act

“Dearly Beloved, we are gathered here today to get through this thing called life.”  This week, music lovers mourned the loss of Prince, but we kept you up to date on the latest happenings in the home health world. Our readers were interested in what MedPAC had to say about moving closer to a single […]

MedPAC Affirms ‘First Step’ Toward New Payment System

The way home health agencies are reimbursed by Medicare could soon change, as members of the Medicare Payment Advisory Commission (MedPAC) voted to move ahead with an overhaul of the current payment system for post-acute care settings. The commission recommends to Congress how much providers should receive in Medicare payments every year, but the commission’s […]

Congress Urged to Cut Home Health Medicare Payments

Home health agencies would see their Medicare reimbursements frozen in 2017 and then reduced starting the next year, if policymakers adopt the latest recommendations from the Medicare Payment Advisory Commission (MedPAC). Therapy visits also should no longer be factored into Medicare payments for home health agencies, according to the commission. “The Congress should direct the […]

MedPAC: Home Health Medicare Payments Too High

Medicare payments to home health agencies are too high and don’t necessarily reflect the cost of a typical episode, the Medicare Payment Advisory Commission (MedPAC) reiterated at a meeting last week. The home health prospective payment system includes the number of therapy visits provided in an episode as a payment factor, and providing more visits […]

Home Health Dramatically Shifts Away from Post-Hospital Care

While home health agencies are crucial post-hospital care providers, they have seen a huge uptick in patients who are not coming out of that setting, recently released Medicare data shows. Between 2001 and 2012, the number of home health episodes not preceded by a hospitalization or a stay in a post-acute setting increased by 116%, […]

Freeze Home Health Payments, Medicare Advisors Again Tell Congress

Home health Medicare payments should not increase next year, considering providers’ unreasonably high margins, a prominent panel of advisors has again stated in its annual report to Congress. Each year, the Medicare Payment Advisory Commission (MedPAC) recommends how Congress should shape Medicare policy. Lawmakers are not obligated to implement the commission’s ideas — and they […]