CMS Releases 2018 Medicare Final Rule for Home Health Agencies

Posted on November 02, 2017

The Centers for Medicare & Medicaid Services (CMS) released a final rule Nov. 1 to update the Medicare fee-for-service home health (HH) prospective payment system for 2018. Highlights of the final rule include:

  • An overall 0.4 percent rate decrease
  • Expiration of the 3 percent add-on for services provided in rural areas
  • Implementation of the last year of the 3-year reduction to the national, standardized, 60-day episode payment rates of 0.97 percent to recoup what the CMS believes to be overpayments for nominal case-mix growth between 2012 and 2014
  • The adoption of three new measures for the 2020 HH Quality Reporting Program. The measures are:
    • Changes in Skin Integrity Post-acute Care: Pressure Ulcer/Injury
    • Application of Percent of Residents Experiencing One or More Falls with Major Injury
    • Application of Percent of Long-term-care Hospital Patients with an Admission and Discharge Functional Assessment and a Care Plan That Addresses Function
  • Removal of 33 items from the HH Outcome and Assessment Information Set assessment instrument collected at various time periods during the HH patient stay

Based on comments received, the CMS did not finalize the proposed new case-mix methodology, known as the home health groupings model, or a reduction in the unit of payment from a 60-day to a 30-day episode of care that was proposed to take effect Jan. 1, 2019. Instead, the CMS indicated that if will further engage with stakeholders in moving toward a revised payment system.

Featured in Monday Report. Click to view the full edition. The MHA will provide members with additional detail regarding the HH final rule, including an updated facility-specific impact analysis. Members with questions should contact Marilyn Litka-Klein at the MHA. 



Tags: home health, CMS, PPS, FFS

Posted in: Member News

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