CMS Cuts Payment Rates, Jeopardizing Access to Home Health While Seeking to Advance Quality and Value
Friday, October 30, 2015
by: Visiting Nurse Associations of America

Section: Breaking News

WASHINGTON  Oct. 30, 2015 – Yesterday, the Centers for Medicare and Medicaid Services (CMS) released two regulations that will have a significant impact on home health agencies in 2016: The final 2016 home health payment rule and a proposed rule to revise discharge planning requirements.

The final payment rule updates the Medicare Home Health Prospective Payment System Rate for CY 2016 and implements a Home Health Value-based Purchasing model in January 2016. The rate update will result in an overall -1.4 percent payment cut to home health agencies (HHAs) in 2016.

“VNAA applauds CMS for advancing quality and value in the home health sector and looks forward to assisting its members and CMS in implementing the value-based purchasing program,” noted Tracey Moorhead, President and CEO of the Visiting Nurse Associations of America (VNAA). “VNAA, however, is disappointed to see CMS move forward with such a significant cumulative cut to home health reimbursement rates for 2016.”

The second major regulation of the day, a proposed rule to revise current requirements for discharge planning is commendable in its focus on patient-engagement and enhanced coordination and communication across the healthcare system. However, as structured the proposed provisions will cost HHAs approximately $300 million to implement.

These regulations and their associated costs come at a time when CMS is working to reorient the healthcare system towards value. The discharge planning rule confirms what VNAA originally commented to CMS in response to the proposed payment rule: Improving performance requires upfront investments. The cuts that CMS finalized in the payment rule and the increased costs associated with the discharge planning rule— together totaling an approximate $600 million negative impact annually—will not only challenge HHA efforts to make the investments needed to improve the value they provide to beneficiaries but also to keep their doors open.

VNAA is committed to advancing quality and value within the home health community and health care industry more broadly. We will continue to look for opportunities to advance these important goals while retaining access to care for Medicare's most vulnerable populations.

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