Home-Based Care Advocates Call for Presumptive Eligibility, Direct Care Workers Fund

Securing direct reimbursement for telehealth visits and a Medicare rate increase are among the top advocacy priorities for home health providers during the coronavirus outbreak. While they share some common goals, home-based care providers that predominantly work under Medicaid have priority lists of their own. David Totaro is the chief government affairs officer for Moorestown, […]

Coronavirus Consequence: Home Health Agencies See Spike in LUPAs

Coming into 2020, home health care providers were preparing for drastic changes to the way that low-utilization payment adjustments (LUPAs) were calculated, a nuance of the Patient-Driven Groupings Model (PDGM), which took effect Jan. 1. However, what no one predicted is how the coronavirus would even further rock the LUPA landscape. Amid the COVID-19 emergency, […]

For Home Health Providers to Support Hospitals, More Federal Barriers Need to Be Lifted

Home health providers are positioning themselves as the answer to lessening the burden on U.S. hospitals during the COVID-19 pandemic, but the federal government will need to continue cutting through the red tape for providers to be effective. The past four weeks have elicited concerns about hospital over-capacity issues, as the number of confirmed coronavirus […]

Home Health Advocates to CMS: Stop Waiting to Cut ‘Meaningless Red Tape’

Officials from the U.S. Centers for Medicare & Medicaid Services (CMS) attempted to provide additional clarity to home health providers responding to the coronavirus pandemic Friday, speaking with stakeholders during a late morning conference call that quickly hit capacity. Among topics discussed, CMS offered guidance on telehealth policies, face-to-face rules and Medicare’s homebound requirement. More […]

HHCN Poll: 31% of Home-Based Care Providers Have Been Affected by COVID-19

Over the past few weeks, nursing home operators have been working in overdrive, trying to avoid a fate similar to the Kirkland, Washington-based long-term care facility devastated by COVID-19. While home health providers are also gearing up for increased patient capacity and challenges associated with the coronavirus, their operations remain mostly stable — for now. […]

As PDGM Nears ‘Prime Time,’ Destabilization Fears Remain

The Patient-Driven Groupings Model (PDGM) is nearing “prime time,” though fears about home health industry destabilization remain. As the largest payment overall to the Medicare home health benefit in decades, PDGM alone runs the risk of negative disruption. When matched with other regulatory headwinds rising at the same time, that risk is drastically magnified, according […]

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 […]

Encompass Health’s April Anthony: Unified PAC Payment Model ‘Could Happen Before PDGM Even Settles’

For home health providers and their policy advocates on Capitol Hill, the Patient-Driven Groupings Model (PDGM) is priority No. 1, 2 and 3. Lurking in the background, though, is possibly an even bigger, more drastic reimbursement overhaul — a unified payment system for the entire post-acute care landscape. Currently, post-acute care (PAC) providers include skilled […]