Articles by Sarah Elliott

  • CareCentrix

    PDGM/PDPM Payment Models: The Impact on Home Health

    Described as the biggest Medicare reimbursement overhaul in 20 years, the recent changes to the Centers for Medicare and Medicaid’s (CMS) payment models have caused a lot of buzz. The reason for all the hype is the transition towards a more value-based system and away from the fee-for-service status quo. The intent behind these administrative changes, commonly known as the Patient-Driven Payments Model (PDPM) for skilled nursing facilities (SNFs) and the Patient-Driven Groupings Model (PDGM) for home health care, is to improve the quality of patient care, promote the overall health and wellbeing of the Medicare Advantage population, and lower healthcare costs.

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  • CareCentrix

    Medicare Advantage Plans and Home Care in 2020

    MA plans are an alternative to traditional Medicare, encompassing inpatient, outpatient, and prescription drug benefits. In 2018, CMS announced that MA plans would expand to cover home-based services as well. The new plans include several new services that are available to millions of MA plan members. Since their introduction in 2010, MA plans have become increasingly popular among Medicare recipients, and the additions planned for 2020 will likely add to this enthusiasm.

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  • CareCentrix

    Medicare Advantage’s Supplemental Benefits

    As the healthcare climate pivots from fee-for-service to value-based payment models, Medicare Advantage benefits are expanding to include a broader scope of offerings. Insurers are slowly realizing that the value of offering these benefits is far greater than paying for treatment costs, including time spent in high-cost, acute care facilities, once a patient’s illness becomes more severe.

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  • Medicare Advantage and Hospice Care

    In January 2019, the Centers for Medicare and Medicaid Services (CMS) announced an expansion of its “value-based insurance design” (VBID) model for Medicare Advantage (MA) plans. With the industry moving away from fee-for-service models and towards fee-for-value arrangements, the Medicare Payment Advisory Commission (MedPAC) has advocated for the addition of carved-in hospice benefits to Medicare Advantage plans, including a test of this offering, starting in 2021.

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  • CareCentrix

    Recapping HLTH’s “Create Health’s Future” 2019 Conference

    HLTH, one of the industry’s largest health innovation events, held its second annual conference, “Create Health’s Future,” featuring more than 6,000 attendees, 300 speakers, and 950 high profile CEOs and founders including CareCentrix CEO, John Driscoll. The digitally focused summit attracted some of the biggest players in health and tech and provided a forum to address healthcare’s highest-priority issues. As the conference title suggests, the dominant theme centered on revolutionizing the future of healthcare across the United States.

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