CMS’s Proposal to Eliminate RAPs, Increase PDGM’s Behavioral Adjustment ‘Death by 1,000 Cuts’

Home health operators and industry advocates are voicing their concerns following a proposal from the Centers for Medicare & Medicaid Services (CMS) to eliminate home health pre-payments and move forward with behavioral assumptions under the Patient-Driven Groupings Model (PDGM). Specifically, many worry the proposed changes will create cash flow problems for home health agencies, which […]

Home-Based Care Ally Adam Boehler to Leave CMMI

A key ally for home health providers and a major proponent of value-based care may be leaving his federal post. The Trump administration revealed late Wednesday it has nominated Adam Boehler — director of the Center for Medicare & Medicaid Innovation (CMMI) and a senior adviser to the secretary of the U.S. Department of Health […]

BETTER Act Calls for In-Home Telehealth Expansion, Unified PAC Payment ‘Prototype’

A relatively little-known bill in the home health care world currently being marked up in the U.S. House of Representatives could have a big impact on providers — and the post-acute care space overall. Introduced on June 21 by Reps. Richard Neal (D-Mass.) and Kevin Brady (R-Texas), the Beneficiary Education Tools Telehealth Extender Reauthorization (BETTER) […]

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 […]