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Payers

Medicare Advantage Plans, Payer, and Provider Partnerships

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Trend #1: Payers Are Accelerating Into the Home-Based Care Market

July-August 2022 Issue
SUBSCRIBER CONTENT How should your organization be responding to payers expanding their position in home-based care? What key trends support this advancement? What are key strategies to partner and align with payers? In this article, we cover the key market changes, the disruption, and growth opportunities for home-based care organizations.

Trend #1: Payers Are Accelerating Into the Home-Based Care Market2022-08-28T13:38:47-04:00

Trend #2: Payers Expanding Home-Based Care Models Nationally

July-August 2022 Issue
SUBSCRIBER CONTENT Payers are deepening their care delivery models focused on the home. In the past, we may have thought of payers in traditional roles as a medical-cost manager. Today, they are acquiring home-based care organizations to control readmissions, cost, and outcomes.

Trend #2: Payers Expanding Home-Based Care Models Nationally2022-08-28T13:38:55-04:00

Trend #3: Highest Chronic Care Conditions in Medicare, Medicare Advantage Plans, And Special Needs Plans

July-August 2022 Issue
SUBSCRIBER CONTENT Different payers such as Medicare, Medicare Advantage, and Special Needs Plans are focusing on the highest chronic care conditions to reduce the cost of care. In this article, is the data by payer and a discussion about how organizations can support a better aligned financial and quality partnerships.

Trend #3: Highest Chronic Care Conditions in Medicare, Medicare Advantage Plans, And Special Needs Plans2022-08-28T13:39:05-04:00

Trend #4: Growth in Medicare Advantage Plans 2022 Signals Future in Managed Care Contracting

July-August 2022 Issue
SUBSCRIBER CONTENT Medicare Advantage enrollment is growing at a fast pace. The number of plans is expanding geographically, and payers will continue to invest in the Medicare Advantage market. In this article, we dig deep into the growth of Medicare Advantage by enrollment, states, and the future. The market signal is strong to put Medicare Advantage contracting as a high priority.

Trend #4: Growth in Medicare Advantage Plans 2022 Signals Future in Managed Care Contracting2022-08-28T13:39:13-04:00

Trend #5: Payer and Home-Based Provider Partnering to Reduce the Cost of Care

July-August 2022 Issue
SUBSCRIBER CONTENT Important to all payers is the value your organization brings to reducing the cost of care. Available data can gear-up your partnership value quickly. In this article, we sliced and diced data to provide an overall macro/micro picture of how to reduce the cost of care.

Trend #5: Payer and Home-Based Provider Partnering to Reduce the Cost of Care2022-08-28T13:39:20-04:00

Is Socioeconomics a Main Influencer of Readmissions?

March-April 2022 Issue
SUBSCRIBER CONTENT Researchers examined the common reasons why some hospitals have more readmissions treating a disproportionate share of patients with low incomes, poor health and other negative circumstances.

Is Socioeconomics a Main Influencer of Readmissions?2022-04-25T19:52:14-04:00

5 Things to Know About Hospice Benefits 2022

January-February 2022 Issue
SUBSCRIBER CONTENT CMS is testing a broad array of complementary MA health plan innovations designed to reduce Medicare program expenditures, enhance the quality of care for Medicare beneficiaries

5 Things to Know About Hospice Benefits 20222021-12-22T16:17:25-05:00

Five Payer Strategies Ramping-up Home Care Usage

July-August 2021 Issue
SUBSCRIBER CONTENT Payers are targeting their member populations that will benefit the most from at-home care. The center of their home health offerings is focused on high-cost patients, palliative care, diabetes, home care visits, telehealth, and at-home testing.

Five Payer Strategies Ramping-up Home Care Usage2022-08-21T11:31:21-04:00

Administering Specialty Drugs at Home

July-August 2021 Issue
SUBSCRIBER CONTENT A recent study found receiving certain forms of care at home instead of in the hospital can lower healthcare spending. Administering specialty drugs at home or in a provider’s office lowered healthcare spending by $4 billion.

Administering Specialty Drugs at Home2022-08-21T11:31:25-04:00

Does Your Organization Have the Right Clinical Service Lines to Reduce the Cost of the Top Five Medical Conditions and Expenditures?

March-April 2021 Issue
New information will help your organization better align clinical services to reduce the cost of the highest medical conditions and their expenditures. The data can be used in conversations with various payer sources to align your organization’s services to reduce the cost of care and readmissions.

Does Your Organization Have the Right Clinical Service Lines to Reduce the Cost of the Top Five Medical Conditions and Expenditures?2022-08-21T11:32:12-04:00

How to Accelerate Business Growth and Technology Innovation for Home Health, Hospice, Palliative Care, and Private Duty Providers

March-April 2021 Issue
National leaders discuss how to lean into new approaches to accelerate growth, improve performance, and address technologies that create faster reimbursement, better work-life balance for clinicians, and optimal patient outcomes.

How to Accelerate Business Growth and Technology Innovation for Home Health, Hospice, Palliative Care, and Private Duty Providers2022-08-21T11:32:22-04:00

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.

7 Models That Will Accelerate Value Based Payments in 20212021-08-30T18:08:26-04:00

Should Your Organization Be Preparing for Greater Value-Based Payments?

January-February 2021 Issue
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.

Should Your Organization Be Preparing for Greater Value-Based Payments?2022-08-21T11:32:26-04:00

2021 Regional Outcomes for Medicare Require Full Financial Risk

January-February 2021 Issue
Geographic direct-contracting model (GEO) is the latest CMS Center for Medicare and Medicaid Innovation (CMMI) model which allows Direct Contracting Entities to accept full financial risk for all traditional Medicare enrollees in their region. Three options enhance Medicare benefits and provide waivers for care in the home.

2021 Regional Outcomes for Medicare Require Full Financial Risk2022-08-21T11:34:02-04:00

2021 Payer Opportunities Collection

Your organization has new opportunities to grow and expand payer partnerships. A one-size-fits-all approach no longer exists, which is why we have bundled four articles from the Nov-Dec 2020 issue of The Remington Report into this complimentary compendium. Read about how to expand internal and external education, leverage critical investments in your workforce, and enhance actionable data needed by payers.

2021 Payer Opportunities Collection2021-08-30T18:08:27-04:00

Payers Expanding Care at Home Models

November-December 2020 Issue
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.

Payers Expanding Care at Home Models2022-08-21T11:34:22-04:00

New Care Models Allow Payers to Take on Risk for Dual-Eligible Beneficiaries

November-December 2020 Issue
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?

New Care Models Allow Payers to Take on Risk for Dual-Eligible Beneficiaries2022-08-21T11:34:38-04:00

The Vulnerabilities of COVID-19 Expand Insurers Capabilities In the Home

September-October 2020 Issue
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.

The Vulnerabilities of COVID-19 Expand Insurers Capabilities In the Home2022-08-21T11:35:16-04:00

Stronger Strategic Partnerships: Data Exchange is a Driving Factor

September-October 2020 Issue
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.

Stronger Strategic Partnerships: Data Exchange is a Driving Factor2022-08-21T11:35:19-04:00

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.

Strategy Insight: How To Align Financial and Clinical Incentives with Payers and the Most Costliest Medical Conditions2021-10-23T11:35:44-04:00

COVID-19 Medicare Emergency Waivers For Discharge Planning And Home Care Providers

July-August 2020 Issue
CMS has provided blanket waivers with a retroactive effective date of March 1, 2020 through the end of the emergency declaration to help providers during COVID-19. We gathered the waivers for discharge planning, in-home care providers, and other post-acute care settings.

COVID-19 Medicare Emergency Waivers For Discharge Planning And Home Care Providers2022-08-21T11:36:30-04:00

Payers: 2020 Supplemental Benefits for Chronic Conditions Doubled

In 2020, Medicare Advantage (MA) plans have doubled the number of condition-specific supplemental benefits from approximately 820 to 1,850. However, the new Special Supplemental Benefits for the Chronically Ill (SBBCI) for 2020 didn’t fare as well.

Payers: 2020 Supplemental Benefits for Chronic Conditions Doubled2021-10-22T17:39:52-04:00

Payment Recommendations for 2021

In its March 2020 report to the Congress, MedPAC makes payment policy recommendations for provider sectors in fee-for-service (FFS).

Payment Recommendations for 20212021-10-22T17:42:48-04:00

Report: Medicare’s Hospital Post-Acute Care Transfer Policy to Hospice

The Bipartisan Act (BBA) of 2018 Act updated the hospital transfer policy for early discharges to hospice care. The law required that, beginning in FY 2019, discharges to hospice care would qualify as a post-acute care transfer and be subject to payment adjustments.

Report: Medicare’s Hospital Post-Acute Care Transfer Policy to Hospice2021-08-30T18:08:30-04:00

Medicare’s Option to Avoid the Emergency Department

The Center for Medicare and Medicaid Innovation’s Emergency Triage, Treat, and Transport (ET3) Model is designed to test expanded care destination alternatives to the ED for Medicare beneficiaries who call 911.

Medicare’s Option to Avoid the Emergency Department2021-10-22T17:43:31-04:00

Medicaid ACO Market Scan

17 states are implementing accountable care strategies in Medicaid or state employee health programs and patterns have begun to emerge.

Medicaid ACO Market Scan2021-10-23T11:59:15-04:00

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