Home-Based Care Providers Limit Medicare Advantage, Medicaid Admissions Amid Payment and Administrative Pressures
A recent survey of home-based care providers reveals that Medicare Advantage and Medicaid payment rates, administrative burden, prior authorization delays, and denials are driving some providers to restrict admissions for certain payers. Providers cite these factors as top operational concerns. The trend affects access to home-based care for Medicaid managed care enrollees and Medicare Advantage beneficiaries. This reflects broader tensions between managed care plans and home health providers over reimbursement adequacy and administrative requirements.
Network adequacy and access to home health services are at risk if providers continue limiting Medicaid managed care admissions due to payment and administrative friction.
Managed Care · LTSS
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