The Centers for Medicare and Medicaid Services (CMS) released on June 6 the "CY 2016 Home Health Prospective Payment System Rate Update; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements." The regulation, if codified, would implement a 1.8 percent (or $350 million) pay cut, new quality measures, and a value-based payment pilot for home health providers. The rate cut is a result of continued rebasing of home health rates, adjustments due to case-mix coding intensity growth unrelated to changes in patient acuity, and adjustments due to productivity.
The proposed five-year value-based payment program would require participation of all home health agencies in nine states. States would be selected based on a set of characteristics including agency size, population density, patient characteristics and service utilization to ensure a nationally representative sample. Participating agencies would be subject to incentives and penalties in the range of 5-8 percent, beginning with 5 percent in the first two years of the program. While the program would begin in January 2016, the first incentive payments or penalties would not be paid until January 2018.
VNAA is evaluating the rule and will host a members-only call on Friday, July 10 at 1:00 p.m. to review the major provisions in the rule. Register here.
VNAA Press Release: "Proposed Payment Rule Slashes Payments to Home Health Providers Jeopardizing Access to Care"