Medicare

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

While home-based medical care has been shown to reduce hospitalization rates and lower costs for both homebound and non-homebound populations alike, it continues to be drastically underutilized in the current health care ecosystem. As a result, there are millions of older Americans — especially those living in rural areas — who are going without the

Home health providers have experienced varying degrees of disruption to their business models over the past dozen or so years, from the Patient Driven Groupings Model (PDGM) to smaller regulatory changes. But at the end of the day, the cost of doing business has gone up. And reimbursement levels don’t reflect that, according to Mark

Health and well-being company Humana Inc. (NYSE: HUM) has spent the past few years adding to its health care services portfolio while aggressively investing around a home-based care strategy. The Louisville, Kentucky-based company has now revealed its latest step in that direction. On Wednesday, Humana announced a wide-ranging strategic partnership with Heal, the in-home primary

The impact of the Patient-Driven Groupings Model (PDGM) doesn’t appear to be universal. In fact, each home health care agency’s performance under the model seems to depend on a few somewhat uncontrollable factors, new PDGM data suggests. “CMS created a model that was based on all claims nationally, but depending on where you are and

The Centers for Medicare & Medicaid Services (CMS) was a little bit off with some of its predictions related to the Patient-Driven Groupings Model (PDGM).  At least, that’s true when it comes to the first four months of 2020, according to Strategic Healthcare Programs (SHP) data unveiled on a recent BlackTree Healthcare Consulting webinar. The

As hospitals continue to experience overcapacity challenges due to the COVID-19 emergency, 911 ambulance crews and community paramedics have found themselves treating more patients at home. Historically, ambulance crews and community paramedics — both of which operate in the emergency medical services (EMS) space — have always provided some degree of care in the home

The number of Medicare-certified home health agencies in the United States is dwindling — and it’s a trend that started long before the Patient-Driven Groupings Model (PDGM) kicked in. From 2018 to 2019, the number of home health agencies dropped by about 3.6%, a decrease of 427 individual providers, according the Medicare Payment Advisory Commission