Articles

As the 2026 Home Health Proposed Rule outlined (the Final Rule was delayed by the shutdown as of this writing), significant reforms are continuing to change our industry. VBP and HHCAHPS changes combine with meaningful payment cuts (>6%) to further challenge HH Providers who struggle to stay above water. PDGM recalibration includes new case weights, […]

What Operational changes produce Improved Clinical and Fiscal Results? Many Home Health Providers who managed care successfully under PPS have found their traditional care management models fail to produce desired results under PDGM. In addition, VBP Expansion reduces payment totals for Home Health, and most agencies fail to qualify for the VBP Bonus through their […]

What it takes to qualify – How many Providers will fail? – What can you Expect? – Is there life after failing to qualify for the VBP Bonus? Home Health Value-Based Purchasing (VBP) Expansion arrived this year, and many Providers are eager to qualify for the bonus payment in 2025. Extensive education has outlined how […]

In this second installment of Rehospitalizations in the VBP area, the obvious must be stated: agencies would be remiss in their path to success if they do not objectively investigate their pre-VBP levels of leadership control. Throughout the history of our industry, multiple areas of operations, currently under leadership management, have hampered HH agencies in […]

It should come as no surprise that CMS has made some sharp left turns in Home Health payment and quality areas, directly impacting how our industry delivers care programming. Their goal remains the same; integrating Home Health with care management processes of other care continuums Providers – how do we do it better, more efficiently, […]

Assure your PDGM success with HHSM’s Utilization Review Model Home Health Strategic Management (HHSM), leaders in the management of Home Health through Utilization Review (UR), are prepared to help your agency assure success in the PDGM era. HHSM is currently working with HH Providers and systems across the country to address the Operational challenges of […]

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Cathy Sorenson was skeptical but desperate. With an average daily census over 400 but a profit margin at a barely surviving level, the President and CEO of Home Healthcare Hospice and Community Services in Keene, New Hampshire, frankly rated her agency’s overall performance as ‘mediocre’ and was ready to try anything to draw the best […]

Over the length of the PPS era, HHSM has developed and employed S.U.R.C.H., their Utilization Review model for Home Health Providers, to outstanding levels of clinical and financial results. Despite an ever-changing PPS model, S.U.R.C.H. has consistently produced increased outcomes, elevated care value, and improved Case-Mix/HHRG results; all while improving quality Star Ratings. Based on […]

This series of articles from HHSM addresses the latest CMS demonstration projects for Home Health; a fraud-preventing protocol that includes a Medicare Prior Authorization of Home Health Services Demonstration project, as well as a Medicare Probable Fraud Measurement Pilot. In this two-part series, we will examine the proposed pilot programs, Home Health integrity concerns that […]