MedPAC Releases 2013 Report to Congress on Home Health Payment
Monday, March 25, 2013
by: VNAA Policy Team

Section: Public Policy and Advocacy

On March 15, the Medicare Payment Advisory Commission (MedPAC) released their yearly recommendations to Congress on changes to Medicare payment. The Commission found that while the number of agencies continued to increase in 2011, the volume of services was level and total payments declined by about 5 percent. MedPAC attributed this decline to reduction in the Medicare base rate. The estimated margin for home health providers in 2013 is 11.8 percent.

MedPAC Home Health Recommendations:
  • The Secretary, with the Office of Inspector General, should conduct medical review activities in counties that have aberrant home health utilization. The Secretary should implement the new authorities to suspend payment and the enrollment of new providers if they indicate significant fraud. (First Recommended March 2011).
  • The Congress should direct the Secretary to begin a two-year rebasing of home health rates in 2013 and eliminate the market basket update for 2012. (First Recommended March 2011).
  • The Secretary should revise the home health case-mix system to rely on patient characteristics to set payment for therapy and nontherapy services and should no longer use the number of therapy visits as a payment factor. (First Recommended March 2011).
  • The Congress should direct the Secretary to establish a per episode copay for home health episodes that are not preceded by hospitalization or post-acute care use. (First Recommended March 2011).

VNAA members and staff met with MedPAC in February to discuss the VNAA and VNSNY Vulnerable Patient Study, home health rebasing in 2014 and hospice payment issues. The primary focus of this meeting was to assist MedPAC in better understanding the needs of vulnerable patients and the nonprofit agencies that serve them.

To read the full report on home health please click here.

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