by Tim Rowan | Jul 26, 2024 | CMS, Editorial, Medicare Advantage, Regulatory
by Tim Rowan, Editor Emeritus Past For at least the last five years, every Home Health conference this reporter has attended has featured at least one keynote speaker or expert panelist complaining about sparse and shrinking payments from Medicare Advantage plans. As...
by Tim Rowan | Jul 19, 2024 | Admin, Editorial, Medicare Advantage
by Tim Rowan, Editor Emeritus UnitedHealth Making Home Health Visits Payer or Competitor…that is the question. According to a report in the Wall Street Journal, and questioned by the insurance industry’s lobbying arm, AHIP, UnitedHealth Group has increased...
by Kristin Rowan | Jul 12, 2024 | Advocacy, CMS, Regulatory
by Kristin Rowan, Editor Chevron Deference “A government agency must conform to any clear legislative statements when interpreting and applying a law, but courts will give the agency deference in ambiguous situations as long as its interpretation is...
by Tim Rowan | Jun 27, 2024 | CMS, Medicare Advantage
by Tim Rowan, Editor Emeritus We have been keeping an eye on the Medicare Advantage business as the number of beneficiaries who switch exceeds fifty percent. In past reports, we have described the federal lawsuits that accuse MA insurance companies of illicitly...
by Kristin Rowan | Jun 13, 2024 | Clinical
by Kristin Rowan, Editor The Home Health Value-Based Purchasing (HHVBP) Model began in 2016 as part of the Home Health Prospective Payment System (HH PPS) final rule. The original model aimed to: Incentivize better quality and more efficient care Study potential...
by Rowan Report | Apr 26, 2024 | Admin, Clinical, CMS, Regulatory
by Johnathan Eaves, Senior Director of Communications, Axxess Treating Medicare patients comes with a level of nuance that is important to understand to ensure that organizations remain compliant and patients receive appropriate care. Standards for quality care and...
by Rowan Report | Apr 26, 2024 | CMS, Medicare Advantage, Regulatory
By Beth Noyce, RN, BSJMC, BCHH-C, COQS CHAP-certified home health & hospice consultant This is part 3 of the 3 in the series, outlining the discussions and implications in adopting new outcome and process measures for Hospice care. The final segment addresses...
by Tim Rowan | Mar 20, 2024 | CMS, Editorial
by Tim Rowan, Editor Emeritus This week, we look at the state of the healthcare industry, vis a vis payers that do not pay. While Home Health and Hospice leaders talk at every gathering about refusing to accept Medicare Advantage clients, some large Integrated...
by Kristin Rowan | Feb 7, 2024 | Admin, Marketing, Regulatory
by Kristin Rowan, Editor Medicare Advantage has multiple measures of success for payment bumps and bonuses. Rehospitalization rates has long been the most important measure of how well a care at home agency is performing, but there are additional measures that can...
by Kristin Rowan | Feb 7, 2024 | Regulatory
by Kristin Rowan, Editor, On Wednesday, January 31, Cigna and HCSC signed an agreement to sell all of Cigna’s Medicare business — including traditional Medicare, supplemental benefits, Medicare Part D offerings, and CareAllies, a value-based care management...
