CMS recently published proposed updates to the Home Health Prospective Payment System (HHPPS) for 2018. The proposal outlines updates to market basket, national 60-day episode payment, per visit rates and any rebasing changes.
It also outlines changes to Home Health Value Based Purchasing Model (HHVBP) and Home Health Quality Reporting Program (HHQRP) standards, and introduces a plan to remove the number of therapy visits as a payment calculation factor.
Highlights of proposed updates:
- 60-day national episode payment rate reduced by 0.97 percent to account for nominal case-mix growth;
- Annual market basket adjustment increased by 1 percent for agencies that submit required quality data;
- P Calendar year (CY) 2018, national standardized 60-day episode payment is $3,038.43;
- P Annual market basket, for agencies that do not submit required quality data, is offset by the 2 percent penalty, resulting in a -1 percent adjustment on all final claims and supply payments;
- PCY 2018 national standardized 60-day episode payment for agencies not submitting quality data is $2,978.26;
- Rural add-on, currently an added 3 percent for care provided in areas defined as rural locations, expires December 31, 2017, with no extension of the rural add on in 2018;
- Overall impact of HHPPS 2018 payment rate updates totals a decreased $80 million in payments to home health agencies;
- Case mix tables have been adjusted again as required. Grouping categories remain the same (early with 0-13 therapy visits; early with 14-19 therapy visits; later with 0-13 therapy visits; later with 14-19 therapy visits; and all episodes with 20+ therapy visits);
- Eight new variables have been added to the proposed 2018 grouper model, 12 variables that are dropped, 14 current variables increased in value, 48 current variable decreases and 50 remain with the same variable points values;
- No changes made to the 2017 outlier calculation revisions;
- New Home Health Grouper Model (HHGM) for 2019 is proposed to replace the current Home Health Prospective Payment System;
- For the HHVBP model, it is proposed to require a minimum of 40 completed HHCAHPS surveys to receive a performance score for all HHCAHPS measures and to remove OASIS measure “Drug Education on All Medications Provided to Patient/Caregiver during All Episodes of Care;”
- Removal of one quality measure and adoption of two new quality measures for HHQRP, in addition to reporting standardized patient assessment data in five categories described under the IMPACT Act.
I highly encourage industry professionals to review the proposed changes and thoughtfully submit comments and questions, as requested by the authors of the proposed rule. When CMS does not hear from professionals, it assumes the industry agrees with the proposals as stated.
Comments can be submitted one of four ways:
Electronically by visiting www.regulations.gov a the “more search options” tab.
By regular mail, using the following address ONLY:
Centers for Medicare & Medicaid Services,
Department of Health and Human Services,
Attention: CMS-1672-P,
P.O. Box 8016,
Baltimore, MD 21244-8016
By express or overnight mail, using the following address ONLY:
Centers for Medicare & Medicaid Services,
Department of Health and Human Services,
Attention: CMS-1672-P,
Mail Stop C4-26-05,
7500 Security Boulevard,
Baltimore, MD 21244-1850
By hand or courier to either of the following addresses:
For delivery in Washington DC—
Centers for Medicare & Medicaid Services,
Department of Health and Human Services,
Room 445-G, Hubert H. Humphrey Building,
200 Independence Avenue, SW.,
Washington, DC 20201
For delivery in Baltimore, MD—
Centers for Medicare & Medicaid Services,
Department of Health and Human Services,
7500 Security Boulevard,
Baltimore, MD 21244-1850
(If you plan to deliver to this address, please call (410) 786-7195 in advance to schedule your arrival with one of the staff members.)
Axxess will continue to provide information on the proposed changes via future in-depth blogs on the HHGM, HHQRP and HHVBP proposals.