Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

Home Healthcare

CMS Shifting Home Health to Value-Based Payments Under New Model

November 1, 2018 - CMS recently finalized a new value-based payment system for home health agencies that would move Medicare reimbursement away from the volume of therapy delivered. Medicare will start to reimburse home health agencies under the Patient-Driven Groupings Model (PDGM) in the Home Health Prospective Payment System (HH PPS) by January 2020. The reimbursement model will pay the agencies based...


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CMS Proposes New Grouping Model for Medicare Home Health Payments

by Jacqueline LaPointe

CMS recently proposed a rule that would implement the Patient-Driven Groupings Model for Medicare home health payments by 2020. The rule would eliminate the current Medicare reimbursement system for home health agencies, which pays home...

Providers Investing in Home Health to Prepare for Aging Population

by Jacqueline LaPointe

Faced with the pressure to reduce healthcare costs as the elderly population rapidly grows, providers plan to shift elder care from hospitals and skilled nursing facilities to the home, healthcare experts explained. According to CMS and...

CMS Extends Home Health Enrollment Suspension to Combat Fraud

by Jacqueline LaPointe

In an effort to reduce Medicare fraud, CMS announced in a new rule that it will extend a moratorium on enrollment of new Medicare home health agencies in Florida, Illinois, Michigan, and Texas. The federal agency also suspended enrollment...

CMS Cancels Home Health Groupings Model, $950M Reimbursement Cut

by Jacqueline LaPointe

CMS recently scrapped the proposed Home Health Groupings Model. The model would have used clinical and patient characteristics rather than the current therapy service use thresholds to determine Medicare reimbursement for home health...

Payer, Provider Collab, Home Health Key to Integrated Care

by Jacqueline LaPointe

WASHINGTON DC - The move to integrated care models that treat the whole individual, not just his medical needs, rests on payer and provider collaboration as well as linking healthcare and lifestyle, Humana’s CEO and President Bruce...

CMS Issues Final Rule on Home Health Medicare Reimbursement

by Jacqueline LaPointe

CMS recently released a final rule that will reduce Medicare reimbursement to home health providers by $130 million, or 0.7 percent, in 2017. Lower Medicare spending on home health services will stem from updates to payment rates, the Home...

AHA Critiques Medicare Reimbursement Changes for Home Health

by Jacqueline LaPointe

The American Hospital Association (AHA) is urging CMS to delay outlier provisions and streamline certain medical billing procedures proposed in a recent document aimed at home health facilities. In June, CMS released a proposed rule that...

Congress Asks CMS to Scrap Prior Authorization for Home Health

by Catherine Sampson

A CMS proposal to require a prior authorization screening for every home health service would be an administrative nightmare and may produce barriers to care for needy patients, a group of 116 lawmakers said in a letter to CMS this...

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