While getting a fair rate is top of mind for home health providers, the ones that are seeing the most success in their negotiations with Medicare Advantage (MA) payers are selling their ability to be a solution. Even before entering negotiations with MA plans, providers should have a clear understanding of the challenging reimbursement environment […]
With the need for long-term services and supports (LTSS) growing, Medicare Advantage (MA) plans are positioned to offer home-based care services through supplemental benefits. That’s one key takeaway from a new data brief from the research and advisory firm ATI Advisory, though MA plans haven’t always been the best administrators of home care. The report […]
The United States relies heavily on family caregivers, so much so that the Biden administration has gone lengths to support them. Still, in order for family caregivers to actually reduce the cost of care in the home, they need to be given the proper resources and education. Otherwise, patients are likely receiving – unbeknownst to […]
During the pandemic, some senior care models succeeded, and some didn’t. The Program of All-Inclusive Care for the Elderly (PACE) was one that did. In 2023, PACE enrollment exceeded 70,000 participants and has seen an over 40% growth in enrollment since 2019. Many home-based care providers have already gotten into PACE. The Jacksonville-based Alivia Care […]
Around 2019, Medicare Advantage (MA) was all the rave among home care providers. That’s because, in 2018 and 2019, two pathways opened for MA plans to provide more benefits to beneficiaries: the primarily health-related benefit pathway and the Special Supplemental Benefits for the Chronically Ill (SSBCI) pathway. Included in those were plenty of areas of […]
Generally, home health agencies have expressed dissatisfaction with payment rates and reimbursement policies set by managed care companies. Negotiations around rates can often be contentious. In 2024, however, providers can win with the correct focuses in mind. “You don’t want a managed care strategy; you want a value-based care strategy,” Anne Tumlinson, founder and CEO […]
People who are 55 years old, and living in a community setting in the U.S., are seeing major disparities when it comes to long-term services and supports (LTSS) needs, a new report from research and advisory firm ATI Advisory found. ATI Advisory found that these disparities exist by examining race, gender and geography. The report […]
Though the vast majority of seniors are living in their communities, as opposed to assisted living or nursing homes, only a third of these individuals are receiving financial support or assistance from Medicaid to pay for home- and community-based services. That’s one takeaway from a recent Kaiser Family Foundation (KFF) webinar. Seniors that aren’t getting […]
Funding for fee-for-service home health care and home- and community-based services ebbs and flows. But the payer source most likely to dictate the future of home-based care providers – across the board – is Medicare Advantage (MA). MA plans aren’t immune to tough rate environments, either. In fact, they’re in one right now. That’s one […]
Diving into value-based arrangements with payers always sounds good, in theory, for home health providers. But it is easier said than done. Providers have to commit to value-based care, but even before that, they need to do their homework to be successful over the long haul. Moving away from fee-for-service and moving toward risk through […]
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