Medicare

Even though InnovAge (Nasdaq: INNV) is already one of the largest Program of All-Inclusive Care for Elderly (PACE) providers in the U.S., the company has plans to go after an even bigger piece of the pie. Maureen Hewitt, president and CEO of InnovAge, talked about the company’s multi-pronged growth strategy on Monday during a conference

Given a choice, the vast majority of U.S. adults would still prefer to receive long-term care in their own homes instead of moving into a nursing facility or senior living community, according to a new study from The AP-NORC Center for Public Affairs Research. But while nearly everyone wants to age in place, few actually

Patients recovering at a skilled nursing facility (SNF) can often be discharged home much sooner than they typically are without resulting in a negative health outcome, new research suggests. And if that were to happen more frequently, it could potentially save the U.S. health care system millions of dollars in post-acute care spending while setting

Changes to the requirements for Medicare provider enrollment could have major consequences for home health providers down the line. Under provider enrollment requirements, the U.S. Centers for Medicare & Medicaid Services (CMS) has the authority to rescind providers’ Medicare enrollment if they are associated with “bad actors” and are at risk for fraud due to

Since last spring, there has been a consistent — and justifiable — narrative that long-term care residents are particularly vulnerable to the deadly COVID-19 virus. New research, however, suggests it’s not so simple. A team of researchers from the Cleveland Clinic and Health Data Analytics Institute (HDAI) explored how the COVID-19 virus affects actual versus

Among its many provisions, last year’s Coronavirus Aid, Relief and Economic Security (CARES) Act pressed pause on the government’s 2% payment cut to all Medicare-reimbursed health care providers. The “sequestration holiday” was immediately seen as a common-sense lifeline for cash-strapped home health providers on the front lines of the COVID-19 pandemic, many of whom had

An innovative care concept designed to keep patients at home and out of skilled nursing facilities (SNFs) is reportedly gaining ground in Congress and among special interest groups. The concept — known as “Choose Home” — is a type of SNF-at-home model that leverages both medical and non-medical home care services for certain patients. LHC

Margins for Medicare-certified home health agencies are projected to remain strong in 2021, despite ongoing challenges tied to the COVID-19 pandemic and the shift to the Patient-Driven Groupings Model (PDGM). Margins are anticipated to be so robust, in fact, that Congress should reduce the 2021 Medicare base payment rate for home health agencies by 5%

Despite the once-in-a-generation COVID-19 pandemic, the home health industry’s transition to the Patient-Driven Groupings Model (PDGM) was pretty seamless. Looking into the not-too-distant future, the U.S. Centers for Medicare & Medicaid Services (CMS) will now likely attempt to make modest tweaks to a handful of key areas, payment experts believe. The agency will do so

It has been six months since the U.S. Centers for Medicare & Medicaid Services (CMS) gave home health agencies and other Medicare providers a reprieve from having to pay back advance and accelerated payment loans. But recoupment for these loans is just around the corner. To avoid future financial headaches, providers must be prepared to

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