Special Report: Legal Perspective on Patient Choice
What are the fraud implications when patients' rights are violated? What is the role of physicians in patients' freedom of choice? The Remington Report gets answers from Attorney Elizabeth Hogue.
3 Secrets for Accelerating Home Health and Hospice Growth and Referrals
How to empower your team, drive efficiency of care, prevent readmissions, and gain a competitive advantage for your home health and/or hospice agency.
The Care at Home Market Shake-Up
SUBSCRIBER CONTENT Payers, health systems, Private Equity firms, and SPAC’s acquisition of care at home companies are quickly changing market dynamics, and signaling change is ahead. This is a must-read to understand trends and insights reshaping the future.
The Four Frustrations Your Referrals are Voicing. Is Your Organization Losing Referrals
SUBSCRIBER CONTENT Your referral sources are the lifeblood of your organization. Ultimately, they will look for relationships with organizations that are easy to work with and that can deliver proven quality care. A new research report reveals the four frustrations felt by your referral sources. A roundtable of your peers' weigh-in with solutions.
Advance Care Planning: Pilot Studies for Care at Home Providers
SUBSCRIBER CONTENT The National Institute of Health advance care planning studies are focusing on the effectiveness of telehealth for patients receiving home-based palliative care and leveraging in home support services to engage patients in advance care planning. Learn more about the pilot studies supporting this research.
What Legal Parameters Establish Patient Choice?
SUBSCRIBER CONTENT The right of patients to choose providers has generated considerable conflict within the provider community. In this article, learn the four key legal sources supporting patient choice and actions your organizations and patients can take to have them enforced.
Are CMS Payment Models Delayed … Or Gone Forever?
SUBSCRIBER CONTENT A review of payment models under CMS’ Center for Medicare and Medicaid Innovation (CMMI) is quietly under review to decide if they will be implemented. Many of these models were popular with care at home providers. We provide insight into each of these payment models.
The Top Six Strategies to Grow and Manage Referral Partners
SUBSCRIBER CONTENT The Remington Report interviews Nick Knowlton to discuss how to manage referrals, grow referrals, exchange communications with referrals, and gain a competitive advantage.
The Four Frustrations Your Referrals are Voicing: Is Your Organization Losing Referrals?
What referring hospitals, ACOs, and physicians want from home health, hospice, palliative care and private duty providers to make their lives easier.
5 Top Strategies to Grow and Manage Referral Partners
For five top strategies, we discuss actionable steps that can be taken by home health, hospice, palliative care, and private duty organizations to gain a competitive advantage.
Solutions to Building a Palliative Care Program in the Ambulatory Care Setting
Educational materials, tools, training, and resources for integrating palliative care into ambulatory care for patients with serious life-threatening chronic illness or conditions.
Market Signals Broaden Continuum-of-Care Services
Expanding continuum of care services is an important strategy for future market positioning. We explore how providers, payers, and physicians are broadening services to expand partnership referrals, create innovation, and ensure sustainability.
How Community-Based Care is Being Redefined
SUBSCRIBER CONTENT Under Andrew Molosky’s leadership, Chapters Health System has combined innovation and creative disruption to shift end-of-life care into a leading community-based population health organization.
Vital to Survival Business Intelligence: Operational, Financial, and Clinical
The compelling ways business intelligence drives actionable results.
4 Strategies to Dramatically Improve Productivity, Volume, and Revenue
National leaders discuss how to lean into new approaches to accelerate business growth, improve performance, and address technologies that create faster reimbursement, better work-life balance for clinicians, and optimal patient outcomes. They share how their organizations address four key questions.
OIG’s Audit: Home Health Telehealth Payments
On a temporary basis, CMS issued blanket Section 1135 to healthcare professionals in response to the COVID-19 public health emergency (PHE). But now the OIG wants to be sure the rules are being followed. This Remington Report special report dives into the subject of home health telehealth payments.
How Community-Based Care is Being Redefined
The shift from end-of-life care to building a continuum-based approach, plus strategies for growth, market position, and innovation revealed.
Remington’s Industry Report 2021 Leadership Perspectives
National leaders discuss how to lean into new approaches to accelerate business growth, improve performance, and address technologies that create faster reimbursement, better work-life balance for clinicians, and optimal patient outcomes. They share how their organizations address four key questions.
7 Models That Will Accelerate Value Based Payments in 2021
This year, several value-based payment models will begin the shift from fee for service to value-based. Earmark this as the transformation of payment reform for care-at-home providers and how they will be paid in the future. This white paper explains the seven value-based models impacting care-at-home providers.
Should Your Organization Be Preparing for Greater Value-Based Payments?
SUBSCRIBER CONTENT Beginning in 2021, several value-based payment models will begin the shift from fee-for-service to value-based. Earmark this as the transformation of payment reform for care at home providers and how they will be paid in the future.
How is Your Organization Prepared to Participate in New Non-Traditional Care-at-Home Models?
SUBSCRIBER CONTENT New choices to receive care at home centers on patients receiving acute level care in the home. Non-traditional care at home models is expanding into a new era. The twist to non-traditional programs is to keep care at home leadership’s eyes wide open about the impact to their organizations. Waivers are changing rules, policies have changed, and the role of who can care for patients in the home is transforming models.
How is Technology Expanding Care at Home and How Does it Effect Your Organization’s Future?
SUBSCRIBER CONTENT The invisible technology boundaries expand the rules of who can offer care in the home, how they will be paid, and it creates a less restrictive policy environment to deliver care at home. The opportunity to reshape care delivery and create a more efficient and cost-effective healthcare system is achievable because of the acceleration and adoption of technology.
How is Your Organization Rethinking Strategic Positioning to Offer Continuum-of-Care Services from Pre- And Post-Discharge to End-of-Life?
SUBSCRIBER CONTENT The question for leadership is how do you want to position your organization? As an integrator? Or as an aggregator? For care at home providers, the goal is to create a post-acute continuum model as patients transition from one care setting to another whether that be in-home personal care services, skilled home health, palliative care, or hospice.
Physicians Expanding Care Into the Home
Home-based medical care models are shaking-up the $260 billion primary care market. Three physician models, new reimbursement models, telehealth, and chronic care management are key drivers.
Physicians Are Expanding Care into the Home
SUBSCRIBER CONTENT Home-based medical care models are shaking-up the $260 billion primary care market. Three physician models, new reimbursement models, telehealth, and chronic care management are key drivers.
Payers Expanding Care at Home Models
SUBSCRIBER CONTENT Building home care capacity will give plans more flexibility to meet patients on their own terms and could improve outcomes. Learn what is changing models of care in the home.
State Medicaid Programs are Expanding Value-Based Payments
SUBSCRIBER CONTENT States are developing plans to increase Medicaid provider participation in and adoption of value-based care models. How will these new payment models work?
Medicare Advantage Plans Expand Supplemental Benefits
SUBSCRIBER CONTENT Medicare Advantage Plans are expanding supplemental benefits in 2021. Learn what services are expanding and how this expands your partnerships.
Medicaid Managed Care are Linking Bonus Programs Tied to Performance
SUBSCRIBER CONTENT States are expanding value-based payments (VBP) in Medicaid and leveraging their Medicaid managed care programs to advance their payment reform goals. We discuss the details.
New Care Models Allow Payers to Take on Risk for Dual-Eligible Beneficiaries
SUBSCRIBER CONTENT CMS' innovation center (CMMI) is about to roll out a new model allowing insurance plans to take on financial risk for patients enrolled in both Medicare and Medicaid. How will this affect payers? What other new models can you expect in the future?
Expanded Access for Rural Communities and Transformation of Care
SUBSCRIBER CONTENT The Community Health Access and Rural Transformation (CHART) Model expands telehealth services, links residents to non-local healthcare providers, and provides more than $8.7 million in grant funding. What are the new opportunities for your organization?
OIG Says Providers Can Offer Services to Caregivers
SUBSCRIBER CONTENT In Advisory Opinion No. 18-05; issued on June 18, 2018; the OIG addressed the circumstances under which providers can establish “caregiver centers” that provide or arrange for free or reduced-cost support services to caregivers in local communities.
6 Ways Care in the Home is Changing Your Business
In this free white paper, The Remington Report shares six ways care in the home is changing the future of healthcare. Leaders will need to address these strategically if they intend to realize continued growth in a significantly changing marketplace.
The No. 1 Reason Why Patients are Not Getting Home Health Care After a Hospital Discharge Referral
In this free white paper, The Remington Report unveils the major reason why patients are not getting home health care after a hospital discharge referral, plus four strategies you can use to boost referrals.
Four Ways to Combat the Under-Utilization of Home Health and Hospice
In this free white paper, The Remington Report offers up four strategies to increase the utilization of home health and hospice in the age of COVID-19.
Home-Based Primary Care: It’s Time to Think Beyond the Clinic Walls
SUBSCRIBER CONTENT Primary care is being rapidly redefined today right before our eyes. As healthcare evolves, patient needs expand and providers must look for new and better ways to achieve a patient-centered model of practice. Read the four reasons home-based primary care is opening doors and opportunities for patients and providers today.
Telehealth: 2021 New Billing Codes for Physician Home Visits and Care Planning
SUBSCRIBER CONTENT CMS has released proposed policy changes for 2021 Medicare payment rates under its annual Physician Fee Schedule. Telehealth codes allow physicians to bill for home visits and care planning. We dive into the codes and what they mean.
Home-Based Primary Care Models are Disrupting the Traditional Primary Care Market
SUBSCRIBER CONTENT Home-based medical care models are shaking-up the $260 billion primary care market. How are integrated primary care delivery models addressing chronic care management in the home?
The Vulnerabilities of COVID-19 Expand Insurers Capabilities In the Home
SUBSCRIBER CONTENT Insurers' strategies to provide greater services in the home are moving rapidly. Changing models have insurers partnering-up with primary care physicians, telehealth, and pharmacies to deliver care in the home. We provide insights to insurers' reactions post COVID-19 and beyond.
Stronger Strategic Partnerships: Data Exchange is a Driving Factor
SUBSCRIBER CONTENT Payers are interested in talking about the data. In particular, they are interested in understanding how home care providers are able to reduce their penalties and increase their rewards in a value-based payment system. Learn how one organization is advancing conversations.
Strategy Insight: How To Align Financial and Clinical Incentives with Payers and the Most Costliest Medical Conditions
In this article, we take a look at data reflecting the costliest medical conditions by payers. This becomes an important strategy as payers begin to move more value-based care contracting into the home care space and look to treating higher acuity patients in the home.
Legal: Managing the Risks of Wound Care
Wound care is a risky business these days. Providers who render wound care services are at risk for many things, including liability for negligent wound care, violation of fraud and abuse prohibitions based on substandard wound care, and liability for abandonment when wound care services are discontinued.
COVID-19 Healthcare Workforce and Revenue Reductions: U.S. Home Health Workforce
A recent survey across the U.S revealed the devastation of reduced revenue, patient’s refusal to accept physician-ordered care, and loss of the workforce.
COVID-19 Healthcare Workforce and Revenue Reductions: Aides and Personal Care Workforce
3.5 million low-wage workers are in the health and social services industry, with the greatest number of those (1.3 million) working as aides or personal care workers
Payers Advancing Knee Replacement Care Into the Home
Aggressive moves by payers teaming up with big players such as CVS are advancing their healthcare programs into the home. How does this impact healthcare organizations?
Case Study: Payer and Provider Model: Managing Higher Acuity in the Home
Landmark estimates about 20 percent of chronically ill patients currently experience a gap in the care they are receiving, which can be addressed through medical care, support and education provided in the home.
Hospital-Level Care in the Home Lowered Costs and had Better Outcomes
A recent study in the Annals of Internal Medicine found that at-home patients fared better than those in the hospital when it came to price and outcomes.
Peer Case Study: Community-Based Paramedicine Model
CMS recently announced the Emergency Triage, Treat, and Transport model, which provides greater flexibility to ambulance care teams to address emergency health care needs of certain Medicare beneficiaries following a 911 call.
CMS Is Rolling Out Community Care Corps: Volunteer Caregivers
How can providers offer support for caregivers? A key way for providers to assist may be to collaborate with charitable organizations in the community.
Encompass Health Case Study
Encompass Health, in collaboration with McKesson, saved 17% to 19% on their supply spend, increased efficiencies, and achieved greater patient satisfaction.
Patients’ Right to Freedom of Choice of Providers – Unexpected Allies
Post-acute providers, patients, and their families have very successfully raised issues with hospital administrations related to patients' right to choose.
8% Physical Therapy Cuts Questioned By Lawmakers
Nearly 100 U.S. lawmakers submitted a letter to CMS concerned about proposed cuts in Medicare payments for physical and occupational therapy services.
CMS Combining Post-Acute Compare Websites Into One
CMS is planning to combine and standardize eight separate Compare websites into one point of entry, offer Medicare beneficiaries a consistent look and feel.
Fraud and Abuse Enforcers Target Discharge Planners Again
Recent federal cases make it quite clear that marketers for home health companies and discharge planners/case managers must just say, "NO!" The "jig is up."
Insight Report: Payment Recommendations 2021
The Medicare Payment Advisory Commission recommended that Congress reduce the payments for Home Health by 7% in 2021.
Largest Home-Based Cardiac Rehab Reduces Readmissions to Less Than 2%
Kaiser Permanente’s virtual cardiac rehabilitation program has enrolled more than 2,300 patients, making it one of the largest such programs in the U.S.
More Deaths Occur in the Home vs. Hospital and Nursing Facilities
For the first time since the early 20th century, the home has become the common place among American’s dying of natural causes.
Post-Acute Business Industry News
Post-acute ACO adds 200 new long-term care facilities, new appointments, home medical equipment acquisitions, mergers and acquisitions, and more.
Arrangements with Referring Physicians and Home Care Providers: Recent Action
Now is the time for all home care providers to review agreements and their practices with regard to payments to referring physicians.
2020 New Models For Chronic Care Management In The Home
The tides are shifting the expectations of home care. Pressure from reimbursement, shifting payment models, and value-based care are driving the change.
Post-Acute Care Transfer Policy: The Overpayment for Discharges
Medicare improperly paid acute-care hospitals $54.4 million for 18,647 claims subject to the Post-Acute Care Transfer (PACT) policy.
Physical Therapists Facing Layoffs Across the Healthcare Industry
Physical therapists once in such high-demand are facing massive layoffs across the industry because of reimbursement changes to skilled nursing facilities .
Chronic Care Management Payments Expand Under The Final 2020 Physician Fee Schedule Quality Payment Program
CMS is increasing payment for transitional care management services provided after discharge from an inpatient stay or certain outpatient stays.
Prior Authorizations: The Saga Continues For Providers
Starting November 1, UnitedHealthcare will not pay for unplanned surgeries in an outpatient setting unless it determines the site is medically necessary.
Proposed Stark Law Reform: What It Means To Post Acute Providers
The proposed rules recognize that incentives are different in a healthcare system that pays for value rather than the volume of services provided.
Fall Prevention: Second-Leading Diagnosis For Readmissions
Falls were the leading reason for readmission among patients whose initial hospital was fall-related and who were discharged to home, even with home care.
Fall Prevention: Second-Leading Diagnosis For Readmissions
Falls were the leading reason for readmission among patients whose initial hospital was fall-related and who were discharged to home, even with home care.
Discharge Planning: Adding Caregivers Reduces Readmissions
Including unpaid caregivers into discharge planning for the elderly patient population reduces readmissions.
Discharge Planning Process Requires Post-Acute Quality Measures And More
New Discharge Planning Conditions of Participation require hospitals to assist patients, their families/caregivers in selecting a post-acute care provider.
Post-Acute Unified Value-Based Incentive Program: 5% Withhold Recommended
A unified value-based incentive program for SNFs, home health services, inpatient rehabilitation facilities, and long-term care hospitals is recommended.
Care Management Challenges and Barriers for High-Cost Medicaid Beneficiaries
A GAO report explored the efforts to manage high-expenditure beneficiaries, which are 5% of all Medicaid beneficiaries but nearly half of all expenditures.
Post-Acute Unified Value-Based Incentive Program: 5% Withhold Recommended
A unified value-based incentive program for SNFs, home health services, inpatient rehabilitation facilities, and long-term care hospitals is recommended.
Strategic Planning: In Pursuit of a Predictable Future
Seven guided questions for strategic planning. Six external trends for home care companies to keep an eye on. 10 challenges ahead for home care companies.
Six Ways PAC Providers Can Partner with Physicians Under Alternative Payment Models (APMs)
Through initiatives that change how heathcare is delivered and physicians are paid, CMS is driving toward the goals of improving quality and reducing costs.
Physician Chronic Care Management (CCM): New Opportunities for PAC Partnerships
Physician and post-acute providers can partner together to provide chronic care management through annual wellness programs visits.
Physician Leadership: Why Post-Acute Integration Matters
In this interview with Dr. Brian Amdahl, we ask questions related to post-acute’s value, payment reform and the challenges ahead.
House Calls – A Physician’s Perspective
House calls markedly improve the quality of life of home-limited patients and their caregivers while dramatically reducing healthcare costs.
Home-Based Medical Care: The Top Six Types of Providers
The top six types of providers who provided home-based medical care (non-podiatry) in both 2012 and 2013 accounted for two-thirds of the providers.
Five Payer and Provider Strategies Changing the Status Quo
Payers and providers are redefining and rethinking how new models of care can move the needle toward value-based care.
Community-Based Services: Paramedics New Role
Community paramedicine is a new model of healthcare in which paramedics function outside their customary emergency response and transport roles.
Emergency Dept. Study: Top 10 Reason Heart Failure Patients Go To The ED
A study in the Annals of Emergency Medicine, looked at why heart failure patients go to the Emergency Room.
Behavioral Health Report: Effective Integration For Seniors With Depression
Study estimates a total annual value opportunity of $31 billion in the Medicare market through integration of mental health medical treatments.
22 Key Facts About Physician CCM Billing
This document answers frequently asked questions about billing chronic care management (CCM) services to the Physician Fee Schedule.
IMPACT Act – A Unifying Payment System for Post-Acute Providers
Congressional approval of the IMPACT Act in October 2014, mandates the development and implementation of a standardized post-acute care assessment tool.
IMPACT Act – Standardized Patient Assessment Data
Section 2(a) of the 2014 IMPACT Act requires post-acute providers to submit standardized patient assessment data, as well as standardized quality measures.
IMPACT Act – Quality Measure Domains
Four healthcare settings must report standardized data using the assessment instruments on at least five of the following eight quality measure domains.
IMPACT Act – New Discharge Planning Rules Impact Post-Acute Providers
Under the proposed rule, hospitals and critical access hospitals would be required to develop a discharge plan within 24 hours of admission or registration.
IMPACT Act – Cross-Setting Standardization for Skin Integrity
n keeping with the requirements of the IMPACT Act, measures for the other domains will be addressed through future rulemaking.
IMPACT Act – Cross-Setting Quality Measure for Medication Reconciliation
CMS has contracted with Abt Associates and RTI International to develop a cross-setting Post-Acute Care measure for medication reconciliation.
MedPAC: Unified Post-Acute Payment Within Reach
The PPS prototype that has been developed accurately predicts resource needs for nearly all patient groups, indicating it can be used to set fair payments.
2019 Guidelines for Home and Community-Based Services
CMS issued new guidance to clarify where Medicaid beneficiaries can receive home- and community-based services as defined in a 2014 regulation.
Managed Care Organization and Visiting Nurse Association’s Elderly Heart Failure Program – A Pilot Study
SUBSCRIBER CONTENT Kaiser Permanente Colorado and VNA-Denver jointly offer intense, consistent education to elderly heart failure patients discharged from the hospital.
House Calls to Frail Elders Reduce Costs, Hospital Use, and Nursing Home Placements
SUBSCRIBER CONTENT The program at Washington Hospital Center has lowered total costs of care and has reduced average inpatient length of stay from 8 to 6 days.
Skilled Nursing Facilities Moving Into Value-Based Payments in 2019
In the proposed rules announced by CMS, SNFs will get an $800 million, or 2.1%, Medicare payment increase under the proposed rule for FY 2017.
Champions of Change: Primary Care Caring for Older Adults
SUBSCRIBER CONTENT Key takeaways from the perspective of primary care office help stakeholders to better understand care management population health models.
Home Health Agency Value-Based (HHVPB) Model Background
All Medicare-certified home health agencies in nine states will compete on value in the HHVBP model, where payment is tied to quality performance.
Examples of Payer Value-Based Incentives with Providers
SUBSCRIBER CONTENT A recent filing by Humana indicates the insurer is instituting a new bonus plan that is not just tied to financial performance, but also to health outcomes.
Nine Building Blocks of Care Management
Successful care coordination programs employ a variety of tools to improve quality of care and reduce costs, including flexibility in design.
Montefiore Health System’s Care Management Program
SUBSCRIBER CONTENT Located in the Bronx and Hudson Valley, New York, Montefiore Health System (MHS) serves one of the poorest and most disproportionately disease-burdened counties in the nation with nearly 80% of the payer mix from Medicare and Medicaid.
Medicare Population Characteristics
In 2011, two-thirds of beneficiaries had three or more chronic conditions, more than one quarter of all beneficiaries reported being in fair or poor health.
