NAHC’s Dombi: We’re Not Going To Be Bullied By Congress, CMS

There’s a flood of changes surging toward the U.S. home health care industry. But thanks to widespread recognition, improved quality and staunch advocacy efforts, providers have never been standing on higher ground. That was the key message delivered by the National Association for Home Care & Hospice (NAHC) leadership Sunday during the Washington, D.C.-based nonprofit […]

PDGM’s Lead Author Gets Candid About Pros, Cons of Revolutionary Model

Set to take effect on Jan. 1, the Patient-Driven Groupings Model (PDGM) is as controversial as it is revolutionary. The model’s therapy changes and behavioral assumptions are two reasons why. Home health operators worry their operations and patients will suffer as a result of those modifications, among others. Even PDGM’s lead author, Lisa Grabert, acknowledges […]

CMS Pauses RCD in Two States Ahead of PDGM — But Moves Ahead in Texas

Good news for home health providers in North Carolina and Florida: The Centers for Medicare & Medicaid Services (CMS) will delay the implementation of Review Choice Demonstration (RCD) so agencies can adapt to the upcoming Patient-Driven Groupings Model (PDGM) first. Providers in Texas, however, won’t be as lucky. CMS announced Wednesday it is moving forward […]

Bill That Could Increase Home Health Labor Costs Signed into Law

A labor bill that widens the scope of who is considered an employee in one state has been signed into law. California Governor Gavin Newsom, a Democrat, signed the legislation Wednesday — potentially creating problems for some home health and hospice providers there going forward. “It will definitely have implications for [home-based] care,” National Association […]

Medicare Expansion Would Have Limited Impact on Home Health Providers

More than half of large employers in the U.S. are in favor of expanding Medicare to Americans under 65 — a change that, if implemented, could give government-reimbursed home-based care providers access to more patients. That’s according to a study from the National Business Group on Health, first covered in Forbes. The survey included responses […]

NAHC’s Dombi: CMS Putting Home Health Providers Under the Gun

Home health providers are under more pressure today than arguably ever before. The immediate battle remains the Patient-Driven Groupings Model (PDGM), which could pose an 8.01% cut to providers if its assumption-based behavior adjustments aren’t addressed through Congressional action. But there are plenty of smaller skirmishes taking place in the background as well, according to […]

Why Home Health Care’s Experience Casts Doubt on a Hospice MA Carve-In

The Centers for Medicare & Medicaid Services (CMS) made waves in January when it unveiled plans to test a hospice carve-in under Medicare Advantage (MA), a step long viewed as “inevitable.” Specifically, CMS officials said they would test the feasibility of a hospice carve-in starting in 2021 through the MA Value-Based Insurance Design (VBID) model. […]

CMS Proposal Takes Home Health Agency Closure Estimates and ‘Lights Them on Fire’

After federal health care policymakers fine-tuned the Patient-Driven Groupings Model (PDGM) last October with a 6.42% cut based on certain behavioral assumptions, some industry experts predicted there would be a modest uptick in home health bankruptcies in 2020. “The last time the industry went through this kind of major change was in the late 1990s […]

Game On: PDGM Encourages Home Health Agencies to ‘Game the System’

When the Center for Medicare & Medicaid Services (CMS) developed the Patient-Driven Groupings Model (PDGM), part of the goal was to fix problems that exist with the currently used Prospective Payment System (PPS). One such problem, government watchdogs say, is agencies prioritizing quantity of care over quality because it often leads to more money. Thus, […]