CMS Proposes Changes to the HHQRP

The Centers for Medicare & Medicaid Services (CMS) issued its calendar year (CY) 2019 proposed home health prospective payment system (HHPPS) rule on Monday, July 2, 2018. In addition to payment updates, CMS is proposing changes to the Home Health Quality Reporting Program (HHQRP). As part of the meaningful measures initiative, CMS proposes to remove the following…

HHGM Proposal Not Finalized in CMS’ 2018 Prospective Payment System Rate Update

The Center for Medicare & Medicaid Service has issued the Calendar Year (CY) 2018 Home Health Prospective Payment System Rate Update final rule on the Federal Register, public inspection page.

CMS indicates that based on the comments received it is not finalizing the HHGM proposal for a new payment model in 2019at this time.

Although this is not the full equivalent of withdrawing the proposal,  it is a clear victory for the home health community that took action to stop the rule from becoming final. NAHC thanks every one who has fought this good fight with us.

“The National Association for Home Care & Hospice extends its sincere thanks to CMS for its serious consideration of the home health community’s concerns regarding the proposed payment model,” said NAHC President William A. Dombi. “CMS’s actions today will help preserve access to care for the three and a half million Medicare beneficiaries who rely on home health services every year. NAHC stands ready to work with CMS to improve the payment model that is the key to continued access to high quality and cost-efficient care in the home for our most vulnerable citizens.”

2018 HHPPS Rate Update

CMS is finalizing a standardized episodic payment rate for 2018 of $3,039.64, which is slightly higher than the proposed rate of $3,038.43. The difference in the rates reflects a change in the budget neutrality factors from the proposed to the final rule for the wage index and case mix weight recalibrations. CMS recalculated these using more recent data available for the final rule.  A slight increase is also reflected in the per visit rates for 2018.

As expected, the rates reflect a market basket update of 1% along with case mix creep adjustment of .97 percent. CMS maintains the proposed outlier policy and a non-routine supply conversion factor of $53.03 as proposed.

Home Health Value Based Purchasing Program  (HHVBP)

CMS finalized the proposed changes to the HHVBP program. The OASIS based Drug education on All Medications will be removed beginning with payment year three.  In addition, CMS finalized the number of completed HHCAPHS surveys that will be used for the HHVBP from 20 to 40 and will apply the 40 survey threshold to payment year one.

Home Health Quality Reporting Program (HHQP)

CMS finalized the majority of the proposals related to the HHQRP beginning in 2019. The exceptions were to not finalize the standardized assessment item for Cognitive Function and Mental Status; Special Services, Treatments, and Interventions; and Impairments.

A more detailed NAHC Report to follow on the changes to the HHQRP.