Three principles are guiding the U.S. Centers for Medicare & Medicaid Services’ (CMS) 2024 updates to the Accountable Care Organization Realizing Equity, Access and Community Health (ACO REACH) model: care coordination, managing health equity-related risks and social determinants of health. Among a number of new requirements, the agency will also require participating organizations to develop […]
Enhabit Inc. (NYSE: EHAB) has confirmed that it will begin considering “strategic alternatives” that could include a potential sale or merger. The Dallas-based home health and hospice provider announced today that it had satisfied the conditions of its Tax Matters Agreement (TMA) with its former parent company Encompass Health (NYSE: EHC). Enhabit emerged from the […]
Evolving network adequacy requirements within the value-based insurance design (VBID) model demonstration have some hospices concerned that Medicare Advantage payers may have narrowed views on reimbursement and access. This year the U.S. Centers for Medicare & Medicaid Services (CMS) introduced changes to the VBID model that included modifications to network adequacy requirements for Medicare Advantage […]
Medicare Advantage plans are connecting the dots between quality scores and care delivery costs. When choosing a hospice to work with, payers in the Medicare Advantage (MA) realm zero in on providers’ quality scores and its patient population growth potential, according to Frontpoint Healthcare CEO Brent Korte. Consequently, those are key data pieces for hospices […]
The U.S. Centers for Medicare & Medicaid Services (CMS) is making significant changes in 2024 to the Accountable Care Organization Realizing Equity, Access and Community Health (ACO REACH) payment model. The updates include the introduction of a new approach to payment designed to enhance care delivery and care coordination for patients in underserved communities, according […]
The U.S. Department of Justice (DOJ) will investigate potential antitrust violations in the UnitedHealth Group (NYSE: UNH) subsidiary Optum’s forthcoming acquisition of Amedisys, Inc. (NASDAQ: AMED). To date, neither Amedisys nor Optum have been accused of any wrongdoing. The DOJ performed a similar investigation when Optum acquired the health care technology company Change Healthcare earlier this […]
Enhabit Inc. (NYSE: EHAB) has announced plans to launch a strategic review process that could result in a potential sale. The consideration marks another move among large home health and hospice providers in the industry. The company is getting ready to explore various transaction options in order to satisfy the terms of its Tax Matters […]
It wasn’t too long ago when Aveanna Healthcare Holdings Inc. (NASDAQ: AVAH) was a company mostly focused on in-home care to pediatric populations. When the Atlanta-based provider filed to go public in April 2021, however, it revealed ambitious plans to expand into the arenas of Medicare-certified home health and hospice care. “We believe that we […]
The Pennant Group Inc. (NASDAQ: PNTG) is on the hunt for hospice acquisitions as previously record-high price tags in the market trend downward. The home health, hospice and senior living company aims to pursue acquisition opportunities across all of its service lines. Higher valuations in home health and hospice have dampened the ability to stretch […]
As regulatory agencies crack down on hospice spending, providers can benefit from recognizing the links between revenue cycle management and compliance. Regulatory activity is increasing on multiple fronts. For example, the U.S. Department of Health & Human Services (HHS) Office of the Inspector General (OIG) has launched a nationwide audit of general inpatient hospice services […]
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