This evening, CMS also released the CY 2018 Home Health Prospective Payment System (HH PPS) Rate Update and CY 2019 Case-Mix Adjustment Methodology Refinements; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements final rule which will be effective on January 1, 2018. Within this rule, CMS announces an overall payment adjustment of -0.4 percent for home health agencies which is estimated to result in a decrease of $80 million in payments.

For the Home Health Value-Based Purchasing (HHVBP) Model, CMS is amending the definition of “applicable measure” to mean a measure for which a competing HHA has provided a minimum of 40 completed surveys (an increase from 20) for Home Health Care Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) measures, beginning with Performance Year (PY) 1. Within the same program, CMS is finalizing the removal of the Outcome and Assessment Information Set (OASIS) -based measure, Drug Education on All Medications Provided to Patient/Caregiver during All Episodes of Care, from the set of applicable measures. Finalized modifications to the HHVBP Model for CY 2018 through 2022 is estimated to save $378 million from a reduction in unnecessary hospitalizations and Skilled Nursing Facility (SNF) usage.

Beginning on January 1, 2019, an additional $146 million in savings is estimated to result from the finalized changes to the Home Health Quality Reporting Program (HH QRP), including: the replacement of one quality measure and the adoption of two new quality measures, data submission requirements, exception and extension requirements, and reconsideration and appeals procedures. CMS also finalized the removal of 235 data elements from 33 current OASIS items, effective with all HHA assessments. CMS is not finalizing the standardized patient assessment data elements that they proposed to adopt for three of the five episode categories.

If you are wondering how this could impact you or your business, please contact Jim Scott at jscott@appliedpolicy.com or 202-558-5272.