Medicare HH Final Rule – Beyond the Basic Financial Implications 

M Aaron Little, Forvis Mazars

The Medicare home health (HH) final rule is important, but what are the financial implications beyond the updated rate provisions?  This session will explore the broader financial landscape facing HH providers, as CMS continues to move towards value-based care.  The HH Value-Based Purchasing (HHVBP) program is more than an opportunity to directly impact finances, it strategically aligns with new mandatory Medicare value-base care models being applied to hospitals, offering HH providers new opportunities to demonstrate value as strategic post-acute care collaborators.  This session will explore how HH providers can strategically position their operations in this evolving financial landscape. 

• Understand the basic financial provisions of the Medicare HH final rule. 
• Gain insights into the new Medicare hospital value-based care models that impact HH providers.
• Identify the financial opportunities presented by the strategic alignment of HHVBP and other Medicare value-based models.

Margin Matters: Finding and Fixing Revenue Leakage in Post-Acute Care

Rob Simione, CPA, Senior Vice President, SimiTree

Reimbursement pressure keeps growing, and home health and hospice agencies can't count on rate increases to protect their bottom line. Margin is often lost quietly, through unbilled visits, coding and OASIS inaccuracies, LUPAs that could have been avoided, late NOAs and NOEs, missing or late physician signatures, avoidable denials, Medicare Advantage underpayments, and hospice cap exposure. This session follows the revenue cycle from referral and intake through final payment. It shows where agencies most commonly leave money behind and the operational, clinical, and financial controls that stop it. Attendees will learn how to use data to spot leakage early, match documentation to reimbursement, lower denial risk under heavier audit scrutiny, and make payer and staffing decisions that improve margin without hurting quality of care.

Learning Objectives:

• Find the most common sources of revenue leakage in home health and hospice operations, from intake through billing.
• Apply controls for coding, OASIS accuracy, documentation, and billing timeliness that reduce denials and lost reimbursement.
• Use key financial and operational metrics to monitor margin performance and make better decisions about payer mix, visit utilization, and staffing.

Optimizing Your Commercial Payer Contract Portfolio

Ellen McCahon, Helms and Company

Margin compression is happening at every turn. Now, more than ever, you cannot afford to have underperforming commercial contracts. This session will walk you through how to analyze your portfolio of commercial payer contracts: both Medicare Advantage and "regular" commercial. You'll be able to see your strong and weak points and develop a contract management strategy that works for your organization.
We will look at:

• The history of the relationship of commercial and government-sponsored payers
• The trend of Medicare Advantage plans market penetration and what this means for Home Health providers
• How to analyze commercial home health contract performance
• How to analyze Medicare Advantage home health contract performance

M. Aaron Little, CPA, Managing Director, Forvis Mazars

Aaron has nearly 30 years of experience with Forvis Mazars and serves as the firm’s home care and hospice industry leader. He oversees a specialized team that provides outsourced billing and revenue cycle functions for home care and hospice organizations throughout the nation.

A leading national home care and hospice consultant, he routinely performs revenue and accounts receivable recovery services, billing operations efficiency and compliance assessments, client training, and other related services. He frequently consults with providers and legal counsel on billing and operations compliance matters, including assisting providers with compliance audits related to mergers and acquisitions or those required by the Office of Inspector General and program integrity contractors. He has extensive experience assisting home health and hospice providers successfully navigate the Targeted Probe and Educate process. Aaron also performs general financial and operational consulting services, including operations reviews, benchmarking, and cost report preparation.

Nationally recognized for his expertise in home care and hospice compliance and revenue cycle operations, he served on the Home Care & Hospice Financial Managers Association (HHFMA) Advisory Board from 2019 to 2022 and was recently reelected for a new term in 2025. He also serves on the HHFMA Workgroup, chairs its Education Committee and is a long-time member and former chair of its Business Analytics Committee. He is also a member of the board of directors for the Indiana Association for Home & Hospice Care and the education committee of the Texas Association for Home Care & Hospice.

Rob Simione, Senior Vice President, SimiTree

Rob Simione is a Senior Vice President at SimiTree, with more than 17 years of progressive accomplishments and leadership in finance, operations and data analytics to support the Post Acute and Behavioral industry. Rob previously served as the Director of Financial Consulting at SimiTree, leading finance and operations teams. As an experienced leader in financial and operational performance improvement with expertise in organizational assessment, budget and financial management, Rob has served in many interim management positions.

A Certified Public Accountant in the State of New York, Rob leads the Consulting and Professional Services teams at SimiTree. Rob has worked closely with a wide variety of organizations to develop financial, operational, marketing and information technology strategies that are crucial to long-term financial planning. Prior to his years in home care and hospice, Rob worked at Price Waterhouse Coopers, where he received the Chairman’s Award for excellence in teamwork. Rob is a member of the Alliance for Home Care and Hospice’s Advisory Group and services as the chair of the Young Professionals and Regulatory committees. He graduated from Villanova University with a B.S. in accounting.

Ellen McCahon, MBA, Principal, Helms & Company, Inc.

Ellen McCahon has over 25 years of experience in the healthcare industry. A Principal at Helms &
Company, Inc., she delivers consulting services to providers who are focused on improving /
transforming their practices to meet the demands of a rapidly evolving healthcare delivery system.

Her proven management and leadership skills have led to demonstrated successes in start-up implementations, business unit performance turnarounds, practice model transformation,
administrative cost reductions and building team-based cultures that maximize individuals’
potential.

Focus areas for Ellen include provider/payer negotiations; business development; association
management; workgroup facilitation; quality improvement project facilitation; operations
optimization; organizational development; strategic planning and financial analytics.
Prior to joining Helms & Company, Ellen had health plan executive roles with a focus on health
management, operations and operations support functions. Most recently, she worked as COO for a Centene, Exchange-based / Medicaid health plan where she had responsibilities for starting up
and overseeing the operations of the health plan as well as driving its growth through the
procurement of multiple Medicaid-based state contracts.

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