CMS Proposes Medicare Home Health Agency Payment Changes
Proposed Medicare home health agency (HHA) payment changes are intended to reduce burdens on providers and improve flexibility of care delivery.
Source: Thinkstock
By - CMS proposed Medicare home health agency payment changes in a new rule intended to reduce provider burdens and advance flexible, transparent payment models in the next two years.
“CMS is committed to helping patients and their doctors make better decisions about their healthcare choices,” said CMS Administrator Seema Verma. “We’re redesigning the payment system to be more responsive to patients’ needs and to improve outcomes. The new payment system aims to encourage innovation and collaboration and to incentivize home health providers to meet or exceed industry quality standards.”
Under the proposal, home health agencies would see an overall decrease in revenues of $80 million.
“The proposed decrease reflects the effects of a 1 percent home health payment update percentage ($190 million increase); a -0.97 percent adjustment to the national, standardized 60-day episode payment rate to account for nominal case-mix growth for an impact of -0.9 percent ($170 million decrease); and the sunset of the rural add-on provision ($100 million decrease),” CMS says.
The rule also would make adjustments to the weighting for case mix, which has grown nominally over the past few years.
This update also would result in the implementation of a 0.97 percent reduction to the national, standardized 60-day episode payment amount to account for case-mix growth. The nominal case-mix growth would decrease payment impact by -0.9 percent ($170 million) along with a rural add-on provision that sets a payment decrease of $100 million.
Other changes in the proposed rule include three new Home Health Quality Reporting Provisions that follow IMPACT Act guidelines. These involve assessment-based use of Outcome and Assessment Information Set (OASIS) data for the following proposed measures:
- Changes in Skin Integrity Post-Acute Care: Pressure Ulcer/Injury
- Application of Percent of Residents Experiencing One or More Falls with Major Injury
- Application of Percent of Long-Term Care Hospital Patients with an Admission and Discharge Functional Assessment and a Care Plan That Addresses Function
CMS included a request for information (RFI) where payers, providers, and related stakeholders can submit ideas and continued feedback on regulatory, sub-regulatory, policy, practice and procedural changes to improve the impact of the proposed rule.
To read the full proposed rule in the Federal Register, please click here.
