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, […]
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, […]
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 […]
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 […]
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. […]
The 27th episode of our podcast, Disrupt, is now available! With 2020 right around the corner, the Patient-Driven Groupings Model (PDGM) is coming in hot. Providers big and small are mostly ready to go at this point — but there’s always something new to learn. For the final Disrupt conversation of 2019 — a year […]
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 […]
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 […]
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 […]
Now that the comment period for the proposed 2020 home health payment rule from the Centers for Medicare & Medicaid Services (CMS) has closed, providers are left waiting to see how things shake out. By far, the most frequently requested change by providers and trade groups alike is the elimination of the Patient-Driven Grouping Model’s […]