Last week, the Medicare Payment Advisory Committee (MedPAC) published its June report to Congress.
The annual June report, which makes recommendations to Congress outlining recommendations for Medicare payment systems, included several areas of interest. These included supplemental benefits and home health care use in Medicare...
The nursing home industry appears relieved Donald Trump was re-elected and many industry insiders are anticipating a swift rollback of the Biden administration's controversial nursing home staffing requirement.
The nursing home staffing requirement is the only major regulatory change for nursing homes after the death of 200,000...
Patients, physicians, home health aides, advocacy groups, stakeholders and more all happily replied to a request for information (RFI) collecting feedback for the Centers for Medicare and Medicaid Services (CMS) on Medicare Advantage data policies and procedures. Turns out, MA isn't very popular among many stakeholders.
The RFI came...
Home care companies are pushing back on Medicare Advantage plans in negotiations for better pay rates and service.
Companies like Addus HomeCare, Interim Healthcare and others are refusing to accept some patients enrolled in Medicare Advantage plans due to low reimbursement rates and issues with prior authorization processes. They...
Last week, the Centers for Medicare and Medicaid Services (CMS) finalized the CY2024 Home Health Prospective Payment System (HH PPS) Rule, which included cuts that cancelled out market basket raises to the industry.
The pay cut is a result of the Patient-Driven Groupings Model (PDGM), which ties reimbursements to patient...
Last Friday, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule for the 2024 Home Health Prospective Payment System. The proposal shocked the home health industry by enforcing an aggregate decrease of 2.2% for Medicare payments to home health agencies (HHAs).
The cut arises from a proposed pay bump of 2.7%...National News
Last week, the Centers for Medicare and Medicaid Services (CMS) proposed two new rules that would require private entities that manage Medicaid and Children's Health Insurance Plan (CHIP) plans to enforce national maximum standards for appointment wait times and will require managed care organizations (MCOs) to monitor compliance.
The...National News
This week in Medicare Advantage news, the home-based care industry is gearing up to assert itself amid concerns that home care services are being inadequately compensated. A new bill modeled on existing Texas law tries to limit the harms caused by prior authorization in Medicare Advantage plans. Also, Centene is concerned about its star...National News
Value-based care is undoubtedly helped by new technologies and information-sharing for providers and insurers alike, but the problems that VBC faces are multifaceted and require more than just an assist from software.
Health information exchanges (HIEs) are in a uniquely strong position to help payers and providers in the quest for...National News
This week, value-based care (VBC) is frequently seen as a method for primary care providers to best serve patients, but increasingly more facets of the healthcare industry are investigating how technology, data analytics and value-based insurance design can help swap volume for value and deliver results for their patients.
Hospitals...National News
Insurance giant Humana released a report on value-based care (VBC), physician progress and patient outcomes based on 2020 data. Overall, the report found that the value-based approach was crucial for providers to deliver care and maintain important channels of communication during the COVID-19 pandemic while also remaining financially...
Prescription drug price negotiations have been a major policy proposal for Congressional Democrats looking to improve the outcome of negotiations surrounding President Joe Biden's Build Back Better agenda in the form of the Reconciliation Bill. Initially, the president and Democratic leadership aimed to expand the ability for the...National News
This month, the Centers for Medicare and Medicaid Services (CMS) released an annual update on the federal government’s official understanding of health spending in the United States through 2019.
Healthcare spending, the modes in which healthcare is utilized by patients, employment for workers and costs can be broken down in...National News
Another example of payers and providers joining forces.
Health insurer Humana is teamed with private equity firms Welsh, Carson, Anderson & Stowe and TPG according to a source for Reuters.
Welsh, Carson, Anderson & Stowe and TPG would take over Kindred’s facility-focused business, which includes long-term acute care...National News
Surveys of DACA beneficiaries show that roughly one-fifth of them work in the health care and educational sector.
That suggests a potential loss of tens of thousands of workers from in-demand job categories like home health aide and nursing assistant.
At the same time, projections by the government and advocacy groups show that the...
