November 12, 2024
(UNH, AMED) Reported Threat of DOJ Complaint Brings Overhang and Extended Invitation to Negotiate
Key Takeaways: We continue to expect that UNH’s acquisition AMED will be completed, despite reports that the DOJ is preparing to sue to block the $3.3B deal on antitrust concerns. While clearly a setback, this…
November 3, 2024
[AMED, EHAB, PNTG]: Final CY25 Medicare Home Health Rates In-Line and Foreshadow Future CMS Rate Pressures
Key Takeaways: Changes to Medicare home health payments live up to expectations of a minimal increase, but with future negative adjustments following CMS’s release of its CY25 final rule Friday. As we wrote in mid-October,…
October 21, 2024
Managed Care Policy Puts and Takes
Key Takeaways: We remain optimistic about the long-term policy outlook for the managed care industry, despite the puts and takes for different business lines associated with the outcome of the upcoming elections on Nov. 5….
October 17, 2024
[AMED, EHAB, PNTG]: History Suggests Slight Home Health Medicare Rate Increase, But Risk of a Cut Remains Unappreciated
Key Takeaways: Medicare reimbursement history suggests home health agencies are in store for a very low single-digit increase YoY in overall Medicare payments and their 30-day base rate when CMS issues its final CY25 payment…
October 11, 2024
Negative Tone Confirmed for CY25 Medicare Advantage Stars and Beyond as Goalposts Continue to Move
Key Takeaways: As we expected, CMS’s release of the CY25 Medicare Advantage (MA)/Part D star ratings continues to limit program “largesse,” making bonus awards more selective and ratings harder to maintain YoY. For CY25, fewer…
October 8, 2024
Negative Tone Ahead for Medicare Advantage Stars While Awaiting CY25 Awards
Key Takeaways: Developments involving Humana (HUM) and UnitedHealth (UNH) last week show CMS remains intent on limiting the financial “largesse” insurers receive in its Medicare Advantage (MA)/Part D (PDP) star rating quality bonus program by…