Nonprofit, Health System-Based Agencies Likeliest to Weather PDGM’s Therapy Storm

A huge portion of existing home health agencies will have to rethink how they delivery therapy services in 2020 in response to the Patient-Driven Groupings Model (PDGM) and its sweeping changes. But nonprofit and health system-affiliated home health agencies appear well-positioned to weather the PDGM therapy storm. That’s according to recent findings from a survey […]

Nearly Half of Home Health Providers Expect to Decrease Therapy Utilization Under PDGM

Nearly half of home health providers anticipate decreasing their therapy utilization in 2020 in response to the Patient-Driven Groupings Model (PDGM), a payment overhaul from the Centers for Medicare & Medicaid Services (CMS) that is partially designed to refocus the industry toward nursing. Among its changes, PDGM shifts home health payment away from existing therapy […]

House Lawmakers Move to Scrap PDGM’s Widely Opposed Behavioral Assumptions

The home health industry won a major victory in its battle to scrap widely opposed provisions of the Patient-Driven Groupings Model (PDGM) Wednesday, as a group of bipartisan House lawmakers introduced a new bill targeting the payment overhaul’s behavioral assumptions. Introduced by Reps. Terri Sewell (D-Ala.), Vern Buchanan (R-Fla.) and Ralph Abraham (R-La.) — along […]

Home Health Industry Reacts to CMS Value-Based Primary Care Initiative

Health care policymakers on Monday unveiled a new voluntary risk-based initiative designed to reward physicians who keep patients at home and away from hospitals. Based upon the work of previous administrations, the new initiative marks a major inflection point for the value-based transformation of the U.S. health care system, according to Department of Health and […]

Home Health Bankruptcies Likely to Rise After PDGM

Although a fairly common practice in the senior housing and skilled nursing worlds, home health providers as a group have largely avoided bankruptcy proceedings, partly thanks to a steady reimbursement landscape and increasing demand for services by older Americans hoping to age in place. If history serves as any guide, that’s likely to change under […]

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 […]

LHC Group CEO: MedPAC ‘Off on Some Island’

In its latest report to Congress, the Medicare Payment Advisory Commission (MedPAC) recommended cutting the home health reimbursement rate by 5% in 2020 while continuing its push for a unified, site-neutral payment system for all post-acute care providers. Those recommendations are short-sighted and fail to recognize the value that home health care providers have created […]

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 […]

Senate Lawmakers Introduce New Legislation Urging Evidence-Based PDGM Changes

Newly introduced bipartisan legislation in the U.S. Senate is targeting the widely opposed behavioral adjustments set to hit home health agencies next year under the Patient-Driven Groupings Model (PDGM). If passed, the legislation would require the Centers for Medicare & Medicaid Services (CMS) to base Medicare reimbursement rates on observed evidence and data, instead of […]