CY 2017 Home Health Prospective Payment System Rate Update; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements
The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule (CMS-1648-P) that would update the Medicare Home Health Prospective Payment System (HH PPS) rates and wage index for calendar year (CY) 2017. The proposed updates to the HH PPS rates include implementing the final year of the four year phase-in of the rebasing adjustments to the national, standardized 60 day episode payment rates, the national per-visit rates, and the non-routine medical supplies (NRS) conversion factor as required by law. In addition, this proposed rule would reduce the national, standardized 60-day episode payment rates by 0.97 percent in CY 2017 to account for nominal case-mix growth between CY 2012 and CY 2014 (i.e., case-mix growth that does not reflect changes in patient acuity), which was not accounted for in the rebasing adjustments finalized in the CY 2014 HH PPS final rule. The CY 2017 proposed rule would result in a 1.0 percent decrease (-$180 million) in payments to HHAs. CMS is also proposing changes to the methodology used to calculate outlier payments. As required by the Consolidated Appropriations Act of 2016, CMS proposes changes in payment for Negative Pressure Wound Therapy (NPWT) performed using a disposable device for patient’s under a home health plan of care. CMS also proposes an update to the Home Health Quality Reporting Program. Lastly, in addition to providing an update on the progress towards developing public reporting of performance under the HH VBP Model, CMS proposes several changes and improvements related to the model.