The ability to successfully navigate the complexities of Medicare reimbursement models remains a top priority for care at home leaders. Despite the evolving and complex payment landscape, there are strategies that leaders can implement to ensure growth and optimize revenue.
Christina Andrews, Senior Director of Professional Services at Axxess, and Mike Carr, Senior Director of Training and Education at Axxess, discussed the concern surrounding payment models discovered in Axxess’ 2025 Care at Home Industry Trends Report. They also noted strategies for success that will be outlined in the upcoming Medicare reimbursement masterclass at the 2025 Axxess Growth, Innovation and Leadership Experience (AGILE).
Ensuring Success
During the discussion, Andrews emphasized the challenges that care at home providers face with new payment models, as outlined in the industry trends report.
In response to that finding, Carr highlighted the practical and dynamic nature of the upcoming AGILE masterclass. The class will cover Medicare reimbursement models, including Patient-Driven Groupings Model (PDGM), Home Health Value-Based Purchasing (HHVBP), and the newest episode payment model, Transforming Episode Accountability Model (TEAM).
He emphasized the value of shared knowledge and practical solutions, as well as the importance of providing actionable takeaways that can be applied across different organizations.
“I think having these actionable takeaways about what’s worked for one organization is something that other organizations can learn from,” Carr said.
Carr also highlighted the need for collaboration between clinical and operational teams, adding that this collaboration is essential for navigating and understanding complex Medicare reimbursement models.
“You need to have that interaction from both the operational as well as the clinical teams to ensure success,” Carr said.
Carr added that the masterclass will bring together both clinicians and executives to foster a shared understanding, ensuring that every part of the organization is aligned.
“We really need to focus on both sides to bring everyone together to make sure we’re all speaking the same language, and really setting ourselves up for success,” Carr said.
Value-Based Purchasing
The pair concluded the discussion by focusing specifically on HHVBP. Carr noted that while competitive, HHVBP can be a very rewarding system, citing the focus on year-over-year improvement.
Carr again emphasized the importance of understanding the reimbursement structure and adopting strategies that can lead to success while avoiding financial penalties.
“There’s certainly the potential for that bonus reimbursement,” Carr said, “but probably equally as important is that need to avoid falling below the median, incurring any kind of financial penalties.”
To learn more about how care at home providers can optimize their revenue and ensure growth, register for AGILE, being held May 5-7 in Dallas.