The Centers for Medicare and Medicaid Services (CMS) on Aug. 22 issued a final rule to refine and update the home health prospective payment system (HH PPS) for CY08. The home health market basket increase for CY08 is 3 percent, which results in $430 million in additional payments to home health agencies in CY08.
Home health agencies (HHAs) that submit the quality data as required under current regulations will receive payments based on the full home health market basket update of 3 percent; HHAs that do not submit quality data will receive only a 1 percent update for CY08.
CMS analysis of the latest available home health claims data, from CY05, indicates a 12.78 percent increase in the observed case mix since 2000--11.75 percent of which is due to changes in coding practices and documentation rather than to treatment of more resource-intensive patients. To account for the changes in case mix that are not related to home health patients’ actual clinical conditions, this final rule implements a reduction in the national standardized 60-day episode payment rate for four years. That reduction will be taken at 2.75 percent per year for three years beginning in CY08 and at 2.71 percent for the fourth year in CY11. CMS is requesting comment on the aspect of the final rule concerning the fourth year’s 2.71 percent reduction to the payment rates. Read the press release. Read a fact sheet with a side-by-side comparison of the 2008 refinements versus current policy.
