Medicare

It’s been 48 days since the start of “no-pay RAPs” in home health care. During this time, providers have had to navigate a sea of challenges and unexpected speed bumps while adjusting to the new process. The U.S. Centers for Medicare & Medicaid Services (CMS) kicked off no-pay RAPs on Jan. 1 of this year.

Two in-home care providers — ConcertoHealth and Perfect Health — announced Wednesday that their organizations have merged. Together, the companies will operate under the name “ConcertoCare.” Aliso Viejo, California-based ConcertoHealth is a value-based care provider organization that delivers a variety of home-based care services. The company’s teams consist of complex care physicians, complex care nurses,

Among payment-related policy changes for the home health industry in 2021 is the elimination of traditional Requests for Anticipated Payment (RAPs) — and the introduction of the “no-pay RAP.” While the change is a potentially costly one for home health agencies, they’re not the only ones struggling to keep up. Medicare Administrative Contractors (MACs) have

Under the Trump administration, federal health care policymakers have long been vocal about the ability of Medicare Advantage (MA) to lower costs and improve outcomes among vulnerable populations. A recent report from the Washington, D.C.-based Better Medicare Alliance (BMA) and consulting firm Avalere Health is now putting hard numbers on that claim, particularly around home

At the beginning of the month, the Centers for Medicare & Medicaid Services (CMS) released the final rule for the 2021 Medicare Physician Fee Schedule. Since then, the rule has drawn criticism for the payment cuts CMS made to home-based primary care visits, a move that experts believe will jeopardize access to care for seniors

U.S. Representatives Brad Schneider (D-Ill.) and David McKinley (R-W.Va.) introduced the Medicare Sequester COVID Moratorium Act last week. If passed, the bill would extend the temporary suspension of Medicare sequestration payment reductions, giving home health agencies and other providers more financial flexibility headed into an uncertain 2021. Since 2014, the U.S. Centers for Medicare &

The home health industry is in a “dynamic state” and evolving into “multiple types of care,” according to the Medicare Payment Advisory Commission (MedPAC). As a result, health care policymakers should start thinking about how to redesign the traditional home health benefit to make it more nimble, perhaps by breaking it up into pre-acute and

As mission-driven organizations, SCAN Group and SCAN Health Plan have leaned into trying to solve some of health care’s biggest problems. In particular, keeping seniors independent and healthy at home has been a major area of focus. SCAN Group is a nonprofit organization focused on helping older adults age in place. Founded in 1977, Long

After one of the closest and most hotly contested campaigns in modern history, President-Elect Joe Biden addressed the nation on Saturday from an outdoor platform in Wilmington, Delaware. While it’s far too early to say what the first 100 days of a Biden administration will look like from a detailed policy perspective, the president-elect has

The U.S. Centers for Medicare & Medicaid Services (CMS) released its final home health payment rule for CY 2021 on Thursday, with essentially no changes to the Patient-Driven Groupings Model (PDGM) or its controversial behavioral adjustment.  In addition to doubling down on PDGM, boosting the home health base payment rate by 1.9% and making minor

As home health and home care operators move toward the ninth month of the COVID-19 pandemic, it’s important to take stock of what has been accomplished from a policy perspective. Many of 2020’s regulatory changes will be fleeting, but others will shape the future of post-acute care for years to come. That was the message

Now that the dust has settled on the Patient-Driven Groupings Model (PDGM), some have returned their attention toward the idea of another major reimbursement overhaul: a unified post-acute payment system. There had been mounting momentum behind a unified payment model for post-acute care providers headed into 2020. The ongoing COVID-19 emergency has derailed a lot

Home health is often utilized as a recovery tool when patients transition out of the hospital because of its ability to improve outcomes. But many of the Medicare beneficiaries who receive referrals after being discharged aren’t actually receiving these services. Overall, the past several decades have seen an increase in the use of post-acute services,

Among its many impacts, the COVID-19 emergency signaled the decentralization of health care and the disruption of M&A activity. When it comes to post-acute care, skilled nursing facilities (SNFs) and other institutional care settings additionally saw patients migrate into the home in order to avoid the spread of the virus. Amedisys CEO and President Paul

Home health providers that have been waiting for the Medicare advance and accelerated loan repayment process to begin will have to wait a little bit longer. While the U.S. Centers for Medicare & Medicaid Services (CMS) has yet to release an official statement, Administrator Seema Verma has confirmed the agency will hold off on the

In an effort to ease the cash flow challenges associated with the COVID-19 emergency, many home health providers took on advance and accelerated payment loans from the U.S. Centers for Medicare & Medicaid Services (CMS). Now, the time has come for the recoupment process to begin. But CMS has been quiet on the matter, creating

Nine months after initially floating the idea, the U.S. Centers for Medicare & Medicaid Services (CMS) has launched Care Compare, a consumer-facing database of provider quality information. The agency announced the launch on Thursday. CMS originally announced its plan to merge Home Health Compare with the seven other Compare sites in January. Agency officials said

Earlier this month, the U.S. Centers for Medicare & Medicaid Services announced it will not immediately pursue a full-blown restart of the Review Choice Demonstration (RCD), a regulatory initiative designed to reduce improper billing in home health care. Instead, CMS outlined how it will move forward with a “phased-in approach” to RCD that gives home

Hoping to create new revenue streams, home health agencies are more frequently turning to Medicare Part B. In fact, some agencies are finding that delivering services under Part B is a natural progression for them. In the case of First Choice Home Health and Hospice, deciding to offer Medicare Part B services was a case

Hospitals improperly coding for post-discharge services contribute to hundreds of millions of dollars in Medicare overpayments. And the majority of incorrect payments are often related to home health services. That’s according to a new audit report from the Department of Health and Human Services (HHS) Office of Inspector General (OIG). The purpose of the OIG

The Centers for Medicare & Medicaid Services (CMS) has proposed a new rule that would make certain COVID-19-related telehealth flexibilities introduced over the past few months permanent for Medicare beneficiaries. The move comes in conjunction with an executive order from President Trump to improve rural and telehealth access.  While CMS’s proposed rule potentially paves the