The Centers for Medicare & Medicaid Services (CMS) isn’t letting up on cuts to home health payments, but its recent rulemaking in Medicare Advantage (MA) may end up benefiting home health providers indirectly. As MA plans become more scrutinized by regulators and lawmakers – and payment updates come with more meager increases – MA penetration […]
Health plans generally do not have great visibility into their members’ care after an acute health event. Even when they do, many aren’t confident in the post-acute care provider that’s serving their member. These findings come from a new survey of health plans conducted by the post-acute care technology company WellSky. Specifically, the survey found […]
In-home health risk assessments and in-home health evaluations are a key part of Medicare Advantage (MA) plans’ strategy. On one end, they help recognize member needs, and help connect those members to other health care services. On the other end, they help boost MA plan profits, quite considerably. A recent study published in Health Affairs […]
Believe it or not, some home health providers have figured out a way to get what they want from Medicare Advantage (MA) plans. At least to a certain extent. Frontpoint Health has become a standout in the industry for running towards MA opportunities with gusto, rather than simply being dragged by the penetration.. From Frontpoint […]
A group of bipartisan lawmakers this week reintroduced legislation aimed at curtailing restrictive – and often flawed – prior-authorization processes within Medicare Advantage (MA). As it has been to most other parts of health care, prior authorization has long been problematic for home health providers and patients. That’s been increasingly true as more insurers have […]
As the Centers for Medicare & Medicaid Services (CMS) cuts fee-for-service Medicare rates and Medicare Advantage (MA) penetration continues, top-tier home health companies are looking for top-tier payers to work with. Enhabit Inc. (NYSE: EHAB) considers itself a top-tier provider – regularly pointing toward its 30-day hospitalization rate, which was 20.5% below the national average […]
The value-based and home-based care enablement platform CareCentrix is in an interesting position. Not only is it in between home health providers and Medicare Advantage (MA) plans, but it’s also now owned by Walgreens Boots Alliance (Nasdaq: WBA) – one of the retailers diving head first into home-based health care services. In a recent conversation […]
Home health providers want better rates and arrangements from Medicare Advantage (MA) plans. The plans, on the other hand, sometimes still can’t figure out what they want from providers. Some of the largest home health companies have begun to make headway with MA plans. “I think the payers are recognizing that this is not a […]
Medicare Advantage (MA) – the offshoot of traditional Medicare that’s administered by private insurance companies – has recently caught a lot of flak. As it pertains to home health care specifically, MA plans have been criticized for their cumbersome prior authorization requirements and provider reimbursement rates that are typically far below fee-for-service Medicare. What’s more, […]
A new study of Medicare Advantage (MA) beneficiaries found that in-home companion care reduced care costs by close to 10%. The study – conducted by a national actuarial firm and commissioned by the companion care company Papa – also found that in-home companion care boosted home health utilization among MA members, while reducing more costly […]
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