As In-Home Care Providers Embrace Medicare Advantage, They’ll Need to Better Manage Vulnerable Populations

Home Health Care News September 8, 2020
Robert Holly

For years now, the U.S. health care system has steadily moved away from a fee-for-service environment toward value-based care. Medicare Advantage (MA) growth reflects this shift, particularly when it comes to the wide spectrum of home-based care.

Currently, the average home health agency gets about 55% of its funding from fee-for-service Medicare, Medicare Payment Advisory Commission (MedPAC) statistics show. MA accounts for roughly 15% of the average agency’s reimbursement stream — a noticeably higher percentage than just even a few years ago.

Although most still operate primarily under private-pay models, non-medical home care providers are increasingly turning to MA, too, propelled by innovative rulemaking from the U.S. Centers for Medicare & Medicaid Services since the start of 2018.

But as...

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