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 14, 2024
Nursing Home Minimum Staffing Rule – Full Reprieve Near Term Unlikely, Potential for Smaller Relief
Key Takeaways: Nursing homes and their post-acute care REIT landlords have legal and legislative reasons to be hopeful about efforts to kill CMS’ minimum staffing rule, but we are skeptical they will secure a full…
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 9, 2024
Harris’ In-Home Care, Vision, Hearing Aid Medicare Coverage Proposal – Likely an Undelivered Promise
We are skeptical of enactment for Vice President Kamala Harris’ campaign proposal to add a Medicare in-home care benefit, along with vision and hearing aid coverage, even if she were to win (our base case)…
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…