Category: ATI Advisory
Individuals that are enrolled in both Medicare and Medicaid — otherwise known as dual beneficiaries — utilize home health care at higher rates than those who are only beneficiaries of Medicare. That’s according to a recent report from ATI Advisory, with support from Arnold Ventures. The report is a profile of the growing population of […]
Home-based palliative care is an untapped business opportunity for many home health and hospice providers in the U.S., but multiple factors continue to hinder near-term scalability. Data on the availability of home-based palliative care is limited, so it’s difficult to pinpoint just how large the market really is. Experts familiar with the space have previously […]
Despite the growing demand for home health services, fraud and abuse guardrails often limit access to the Medicare benefit, a recent Bipartisan Policy Center (BPC) report suggests. The report highlights BPC’s recommendations for the U.S. Centers for Medicare & Medicaid Services (CMS) on how to improve home health services for Medicare fee-for-service beneficiaries. “Given the […]
Compared to fee-for-service Medicare, seniors save close to $2,000 on average in total annual health care spending with Medicare Advantage (MA). That’s according to a new study — based on 2019 Medicare Current Beneficiary Survey data — from Better Medicare Alliance, which features an analysis conducted by the Washington, D.C.-based research and consulting firm ATI […]
New data relating to Special Supplemental Benefits for the Chronically Ill (SSBCI) has been released. And while there are plenty of kinks to work through before these benefits become a significant revenue driver for home-based care agencies, their increasing popularity is undoubtedly encouraging. The Centers for Medicare & Medicaid Services (CMS) unveiled a pathway for […]
On Wednesday, the Senate Special Committee on Aging Chairman, Sen. Bob Casey (D-Pa.), held a hearing to highlight the importance of home- and community-based services (HCBS) for seniors and people with disabilities. He also attempted to explain the broader impact that investment in the sector can have. “Underinvestment in caregiving affects all of us — […]
Medicare Advantage (MA) supplemental benefits adoption has been slow by some measures and rapid by others. A new report from the consulting firm Milliman offers a look into that dynamic and shows exactly where each of those benefits stands in 2022. Among the primarily-health related benefits, in-home support services (IHSS) remains the most popular benefit […]
Nick Loporcaro joins The Vistria Group The former CEO of Landmark Health, Nick Loporcaro, has joined the The Vistria Group as a senior operating partner for its health care team. Loporcaro served as the CEO of Landmark, which is an in-home medical care provider, for over three years. The company was acquired by UnitedHealth Group’s […]
Many of the in-home supplemental benefits offered by Medicare Advantage (MA) plans are new. But whether they are through the primarily health-related pathway, which began in 2019, or through Special Supplemental Benefits for the Chronically Ill (SSBCI), which came a year later, these benefits are still being experimented with. Generally, the plans offering these new […]
New data relating to Medicare Advantage (MA) benefits is on its way out for the new year. And finally, it looks as if optimistic home-based care providers that view MA as a potential revenue stream in the near- and long-term future are seeing their bullishness validated. Just 267 MA plans offered Special Supplemental Benefits for […]
More Medicare Advantage (MA) plans are offering in-home support services as supplemental benefits. That’s according to a new report from Washington, D.C.-based research and advisory firm ATI Advisory. The report included interviews with health plans, providers and advocates to gauge the progress on uptake for primarily health-related benefits and Special Supplemental Benefits for the Chronically […]
October is normally a pretty eventful time for home health and home care operators. This year will certainly be no different, particularly when it comes to emerging Medicare Advantage (MA) opportunities. As Medicare-certified home health agencies await the final payment rule that comes out at the end of October, home care companies will be closely […]
Access to long-term services and supports (LTSS) in the U.S. remains limited, which currently puts seniors in need in a bind. Their options are often such: spend down on savings and assets in order to qualify for Medicaid, or rely on unpaid family care or other informal services. A new study from the Washington, D.C.-based […]
Home care companies looking to lean into Medicare Advantage (MA) opportunities in their markets will have to plan prudently. That planning must be pretty comprehensive, too, as there’s no silver bullet to winning MA business. That’s according to ATI Advisory founder and CEO Anne Tumlinson, who spoke at the Home Health Care News Medicare Advantage […]
The Medicare Advantage (MA) market is controlled mostly by big payers, as the top 10 plans control over 75% of the market. Then there is a 50-foot cliff. Yet at the bottom of that cliff, there are the smaller MA payers who are often more willing to explore and innovate to stand out. Examples of […]
A delay in the Global and Professional Direct Contracting Model by the Biden administration has put the already-accepted direct-contracting entities (DCEs) in a coveted position. New entrants are no longer being accepted for participation in the model while the Centers for Medicare & Medicaid Services (CMS) and its innovation arm review the details. That gives […]
There are several trends shaping senior care in the United States, with two of the biggest being continued Medicare Advantage (MA) growth and the steady shift of health care into the home. Yet if in-home care operators want to capitalize on those trends, they’ll have to break through traditional payment and operational barriers. That’s particularly […]
The Global and Professional Direct Contracting Model — a Center for Medicare & Medicaid Innovation (CMMI) creation — has been put on pause. The holdup is just another example of CMMI pumping the brakes on an alternative payment model in the days since the new Biden administration took over the executive branch. Broadly, the Global […]
Home-based care insiders have been saying for a long time what a wider group of people are now: Care needs to be brought into the home more frequently — and quickly. But accomplishing that won’t be so simple. In fact, turning the nation’s long-term care system into one that allows more seniors to age in […]
The anecdotal claims from home health insiders were true: Across the country, home health agencies gained a greater share of discharges from short-term acute care hospitals during the public health emergency. Specifically, the percentage of patients discharged into home health care rose 1.8% from March to May of 2020, from 17% to 18.8%. That would […]
In September, the U.S. Centers for Medicare & Medicaid Services (CMS) released high-level data suggesting a huge expansion of new Medicare Advantage (MA) supplemental benefits for 2021. CMS followed that up with specific information on MA supplemental benefits under the “primarily health-related” pathway a month later, catching home care providers’ attention due to strong numbers […]
Patients discharged from hospitals are increasingly headed to home health agencies, a new analysis from ATI Advisory shows. In May 2019, of the 801,464 patients discharged from short-term acute care hospitals (STACHs), 11% were sent to home health agencies. In May 2020, of the 558,296 patients discharged from STACHs, 19% went to home health agencies. […]
A number of major Medicare Advantage (MA) carriers are expanding their supplemental benefit offerings shaped around in-home care next year. UnitedHealthcare, the insurance arm of UnitedHealth Group (NYSE: UNH), is among them. Overall, UnitedHealthcare partners with more than 1.3 million physicians and care professionals across the U.S., plus another 6,500 or so hospitals and other […]
With hundreds of plans reportedly offering in-home support services in 2021, the coming year is certain to bring more Medicare Advantage (MA) opportunities for home care agencies. But some home care operators will have more opportunities than others due to geographic variability across the MA landscape. To find leads, agency leaders will need to understand […]
The U.S. Centers for Medicare & Medicaid Services (CMS) last month released new Medicare Advantage (MA) figures highlighting a massive expansion of plans offering home-focused supplemental benefits in 2021. The agency shared additional data on Wednesday — and it now appears the ongoing home care MA movement is even bigger than originally anticipated. “These benefit […]