CMS projects that Medicare payments to home health agencies in CY 2017 would be reduced by 1.0 percent, or $180 million based on the proposed policies. The proposed decrease reflects the effects of the 2.3 percent home health payment update percentage ($420 million increase); the rebasing adjustments to the national, standardized 60-day episode payment rate, the national per-visit payment rates, and the non-routine medical supplies conversion factor ($420 million decrease); the effects of the -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 ($160 million decrease); and the effects of the proposed increase to the fixed-dollar loss ratio used in determining outlier payments from 0.45 to 0.56 for an estimate impact of -0.1 percent ($20 million decrease).

Proposed changes include:

• Rebasing the 60-day episode rate
• Updates to reflect case-mix growth
• Negative pressure wound therapy
• Change in methodology and the fixed-dollar loss ratio used to calculate outlier payments
• HH Value-Based Purchasing Model

CMS also proposes to adopt four measures for the CY 2018 payment determination to meet the requirements of the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act). Three of these measures are resource-based and calculated using Medicare claims. The fourth measure is assessment-based and is calculated using Outcome and Assessment Information Set (OASIS) data. Proposed measures:

• All-condition risk-adjusted potentially preventable hospital readmission rates
• Total estimated Medicare spending per beneficiary
• Discharge to the community
• Medication reconciliation

For More Information:

• Proposed Rule (CMS-1648-P): Comments are due no later than 5 pm on August 26, 2016
• HH PPS website
• HH Value-Based Purchasing Model webpage
• Home Health Quality Reporting Requirements  webpage