Final Rule ‘Blunts Immediate Impact,’ But CMS-Home Health Industry Core Disagreement Remains

Nearly five months after the unveiling of the proposed payment rule caused a stir among home health stakeholders and advocates, the U.S. Centers for Medicare & Medicaid Services (CMS) released its final payment rule on Monday. Back in June, CMS proposed a 4.2% aggregate decrease for 2023, a cut the industry at large felt would […]

Home- And Community-Based Services Make Up $69.5 Billion Of Fee-For-Service Medicaid Expenditures

Total Medicaid managed care spending across all 50 states saw an increase last year. In fact, spending checked in at $420.5 billion in 2021, compared to $359.6 billion in 2020, according to data collected in the annual CMS-64 Medicaid expenditure report. Additionally, home and community-based services make up a big chunk of this spending. At […]

A Top Performer Of The ‘Independence at Home’ Demonstration Explains Its ‘Secret Sauce’ For Success

The Centers for Medicare & Medicaid Services’s (CMS) Independence at Home demonstration aims to find out if delivering comprehensive, home-based primary care can lead to positive outcomes and lowered costs. One demonstration participant, Northwell Health, has been able to realize this goal. Broadly, the Independence at Home demonstration allows Medicare beneficiaries who have multiple chronic […]

CMS Administrator Chiquita Brooks-LaSure Reemphasizes Home- and Community-Based Services Focus

On Tuesday, the U.S. Centers for Medicare & Medicaid Services (CMS) took the time to map out the federal agency’s strategic plans and key initiatives moving forward. During the national stakeholder call, CMS Administrator Chiquita Brooks-LaSure, CMS Chief Operating Officer Jon Blum and Deputy Administrator and Director of Center for Medicaid and CHIP Services Dan […]

Home Health Sector Remains Area of Focus For Fraud Watchdogs

The federal government saw a return of nearly $1.9 billion in health care fraud settlements and judgments in 2021. Of this $1.9 billion, the Medicare Trust Funds received $1.2 billion, and the U.S. Centers for Medicare & Medicaid Services (CMS) received roughly $98.7 million. The Health & Human Services Office of Inspector General’s (HHS-OIG) annual […]

Home-Based Care Providers Sue CMS, HHS Over COVID-19 Relief Funds

A group of New York home-based care providers are taking aim at the Department of Health and Human Services (HHS), the New York State Department of Health (NYSDOH) and the U.S. Centers for Medicare & Medicaid Services (CMS) in a lawsuit filed Friday. Broadly, the case alleges unfair distribution of funds from the American Rescue […]

North Carolina, Florida Home Health Providers Navigate RCD Changes

The U.S. Centers for Medicare & Medicaid Services (CMS) is giving home health providers in North Carolina and Florida time to acclimate to the full implementation of Review Choice Demonstration (RCD). For providers in North Carolina and Florida, the rollout of RCD has meant keeping an eye out for key changes.  Broadly, the purpose of […]

Health Care System Can’t Afford to Make Blockbuster’s ‘Netflix Mistake’ with In-Home Care

The federal government and other private stakeholders play an important role in addressing the unique challenges of accelerating hospital-at-home delivery. That’s according to a group of health care experts who spoke on the future of hospital-at-home models during a Friday webinar hosted by the Leonard Davis Institute of Health Economics at the University of Pennsylvania. […]

New PDGM Adjustments Make It Tougher to Reach ‘Medium’ or ‘High’ Functional-Impairment Levels

Home health operators have to navigate numerous regulatory and policy changes to stay in business. Two major ones surfaced within days of each other last week. The U.S. Centers for Medicare & Medicaid Services (CMS) released the home health final payment rule on Nov. 2, then the federal government announced COVID-19 vaccination requirements for health […]