A new report from the Kaiser Family Foundation shines further light on how popular home- and community-based services (HCBS) are in the U.S. It also makes clear how much cheaper HCBS delivery is for states in comparison to institutional-based care. In 2020, Medicaid programs spent an average of $36,275 per individual on HCBS. They spent […]
Category: Medicaid
A proposed rule from the U.S. Centers for Medicare & Medicaid Services (CMS) – which would require at least 80% of Medicaid reimbursement for home- and community-based services go toward worker compensation – received over 2,100 submissions during its public comment period. Many of the comments included gratitude and appreciation for CMS regarding its efforts […]
The cost of out-of-pocket home care services in the U.S. has steadily risen. As a reaction to that, some providers are proactively relying less on their private-pay revenue streams. While costs have gone up, so has revenue. Private-pay home care providers generally bill two times more than what they pay caregivers, meaning they can hand […]
Home-based care providers working with Medicaid managed care plans have to navigate an operating environment that is more administratively complex. That’s one of the key takeaways from a recent webinar hosted by the National Association for Home Care & Hospice (NAHC). Since 2020, states like North Carolina, Oklahoma and Idaho have implemented managed care programs. […]
Home-based care providers — both big and small — are struggling at the negotiating table with Medicare Advantage (MA) plans. But they’re also struggling in negotiations with managed Medicaid plans. While MA plans and managed Medicaid plans operate a bit differently, providers are having similar issues with both. Proving value to health plan leaders is […]
The U.S. government is projected to accelerate its spending on home health services in 2023. Then, from 2025 to 2031, annual home health spending will grow at a rate faster than any other health care category. That’s according to new estimates from the Office of the Actuary at the Centers for Medicare & Medicaid Services […]
Of all the challenges home-based care providers are facing, it’s the U.S. Centers for Medicare & Medicaid Services’ (CMS) proposed rule regarding Medicaid access that is top of mind for Addus HomeCare Corporation (Nasdaq: ADUS) leaders. Addus Chairman and CEO Dirk Allison called CMS’s proposal the company’s “biggest challenge” over the past several weeks. “They’re […]
Three major home-based care groups are asking the U.S. Centers for Medicare & Medicaid Services (CMS) for more time to review the agency’s recent Medicaid proposal, which features a handful of provisions that could prove challenging for operators. Among those provisions mandate thresholds on reimbursement, in which CMS would require that at least 80% of […]
The U.S. Centers for Medicare & Medicaid Services (CMS) recently published two proposed rules that have major implications for home-based care providers. The provision that has created the greatest waves among providers and industry stakeholders is the potential requirement that at least 80% of Medicaid payments for personal care, homemaker and home health aide services […]
According to the most recent data, an estimated 5.8 million people utilize home- and community-based long-term services and supports (LTSS). Medicaid is the primary payer for LTSS. The U.S. spent over $400 billion on LTSS in 2020, nearly 10% of all health care expenditures. More than half of that spending went toward home- and community-based […]
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