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Exploring Home Health Care’s ‘Convener Problem’

Exploring Home Health Care’s ‘Convener Problem’

When it comes to payment, there are generally two issues that are drawing the ire of home health providers of late: the Centers for Medicare & Medicaid Services’ (CMS) proposed rule for CY 2023 and subpar Medicare Advantage (MA) rates. 

A third one has been added to that list: the role of conveners.

As with most issues in home health care, it bubbled below the surface for a while, then someone finally said it aloud. Now, it’s formed somewhat of a movement.

It started with LHC Group Inc. (Nasdaq: LHCG) CEO Keith Myers on the first day of National Association for Home Care & Hospice’s (NAHC) Financial Management Conference. He pointed out that he thinks conveners – or “middlemen” – are the real problem in the MA-home health provider relationship.

Two days later, a home health operator posed a question to a panel of experts: “These intermediaries, these companies that tell managed care how to save money by denying care, and then take a layer of the revenue for that service – are they not worse for us than the Medicare Advantage plans themselves?”

There was a pause.

“Is that a rhetorical question?” one expert responded.

Since then, I’ve spoken with both home health operators and conveners to get a better idea on just how pervasive this convener issue is in home health care. And that’s the topic of today’s members-only, exclusive HHCN+ Update.

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