Category: ATI Advisory

  • Report Finds Dual-Eligible Individuals Use Home Health Care at Higher Rates

    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 […]

  • Payment ‘Patchwork’ Limiting Near-Term Scalability of Home-Based Palliative Care

    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 […]

  • Bipartisan Policy Center Makes Recommendations to CMS Aimed at Increasing Home Health Access

    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 […]

  • Home Care Providers Take Note As Medicare Advantage Grows, Creates Savings for Seniors

    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 […]

  • Over 4 Million MA Beneficiaries Have At-Home Care Access Through Supplemental Benefits

    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 […]

  • Medicare Advantage Benefits in 2022 Target Home as a Setting, Diabetes as a Condition

    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 […]

  • Evaluating Home Care’s Progress in Medicare Advantage

    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 […]

  • 14% of MA Plans Will Offer Primarily Health-Related In-Home Support Services in 2022

    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 […]

  • What Home Care Operators Can Expect from MA Plans in 2022

    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 […]

  • Increasing LTSS Access Could Cost Up to $12.8 Billion Per Year

    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 […]

  • Why Home Care Providers Should Stand Strong in Negotiations with MA Plans

    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 […]

  • Smaller MA Plans Are Leveraging the Home to Get Ahead

    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 […]

  • Direct-Contracting Entities Figuring Out How to Capitalize on Competitive Advantage

    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 […]

  • In-Home Care Providers Must Break Through Barriers to Handle More Long-Term Care Volume

    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 […]

  • Number of MA Plans Offering SSBCI ‘Social Needs Benefit’ Up 568% in 2021

    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 […]

  • New Data Confirms More Patients Are Being Discharged to Home Health Agencies

    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. […]

  • UnitedHealthcare Advances Home Strategy, Expects to Make 1.7M House Calls in 2020

    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 […]

  • Number of MA Plans Offering In-Home Support Services to Increase by 93% in 2021

    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 […]