Care Delivery Innovation
Expert articles and analysis related to care delivery innovation.
AI Summary — Last 30 Days
CMS is tightening the operating environment for post-acute and home-based care while still signaling interest in value-based delivery: the agency’s nationwide six-month enrollment moratoria for new home health agencies and hospices, expanded fraud enforcement, and push for Medicaid Section 1115 budget neutrality all point to a Trump administration strategy of pairing care-at-home growth with stricter program-integrity and fiscal controls (home health/hospice moratoria). At the same time, evidence that the federal Home Health Value-Based Purchasing model is linked to reduced dementia-care disparities and HCTTF’s Oshi Health GI case study reinforce a longer-term shift toward condition-specific, multidisciplinary models that can manage total cost and outcomes outside institutional settings (Oshi GI model). For ACOs, MA plans, and Medicaid managed care organizations, the strategic tension is clear: scale home- and specialty-based care redesign, but build stronger compliance, referral, documentation, and access-monitoring infrastructure as CMS and federal investigators scrutinize fraud, supplemental payments, and MA barriers to rehab care.
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AAFP Statement - Health Insurance Companies Need to Expand Coverage and Payment of Telehealth, Virtual Check-ins, and E-visits - American Academy of Family Physicians | AAFP
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