Medicare Finalizes Home Health Payments for 2014

A final ruling on home healthcare payments has been issued for 2014, and is designed to better align Medicare payments with home health agencies’ costs providing care, while lowering costs to taxpayers and the 3.5 million Medicare beneficiaries who receive services, according to the CMS.

Under the Home Health Prospective Payment System (HH PPS), the 2014 final rule reduces Medicare payments by 1 percent. This amount reflects the combined effects of an increase in the home health payment update percentage of 2.3 percent, offset by a decrease of 2.7 percent — the result of rebasing the adjustments required by the Affordable Care Act (ACA) — and a .6 percent decrease due to a refinement of the HH PPS Grouper.

The final rule reduces the number of home-health quality measures reported by home health agencies (HHAs). As required by the ACA, CMS must begin phasing in rebasing adjustments to the national, standardized 60-day episode payment rate, the national per-visit payment rates and the NRS conversion factor to reflect changes since the inception of the HH PPS, including:

  • The change in the number of visits in an episode,
  • The mix of services in an episode,
  • the level of intensity of services in an episode, and
  • The average cost of providing care per episode.

Prior to the ACA, rates were based on analyses of home health agency cost and service utilization data available in 2000, when the HH PPS originally was implemented.

The final rule adds two new quality measures, which will require HHAs to report unnecessary hospital readmission rates and preventable trips to the emergency room (ER).

The final rule (CMS-1450-F) can be viewed here. This link will change once the final rule is published in the Federal Register on December 2, 2013.

Source: CMS , November 22, 2013

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