Home Heath

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  • 1.  Medicare Advantage Rates

    Posted 06-09-2022 09:30 AM
    Doers anyone know if there are any rules about how MA plans pay for home health.  Everywhere I've been, they pay according to PDGM, but we are  now being offered their commercial rates form one plan, which are very low.

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    Joseph Larkin BSN, RN
    Executive Director
    Ingalls Home Care and Hospice
    Harvey IL
    (708) 331-0226
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  • 2.  RE: Medicare Advantage Rates

    Posted 06-24-2022 04:11 PM
    Our largest payer is a Medicare Advantage plan and they pay per visit (no HIPPS code, no LUPA threshhold, etc) and they have not updated their rates in 4 years.  I do not think there are rules about how they pay.  Both of our two major MA plans require a preauthorization/reauthorization process as well.

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    Amy Genthe
    Lead Quality Manager
    Porter Hills Home Health West
    Grand Rapids MI
    agenthe@mybrio.org
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  • 3.  RE: Medicare Advantage Rates

    Posted 06-27-2022 11:52 AM

    If contracted with a MC Adv, plans pay per visit.  If not, they pay PDGM.  The problem we see if the contracted plans are taking a sequestration from the already low per visit payments.  We are going appeal this, fingers crossed they stop.

     

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