Home health care is a formal, regulated program of care delivered by a variety of health care professionals in the patient’s home for the treatment of a medical condition, illness or disability. Home health is provided through certified home health agencies (HHAs).
As components of the post-acute continuum of care, HHAs provide essential health care services. This specialized support allows patients to remain at home when they would otherwise have to be admitted to a costly institutional setting, such as a skilled-nursing facility or hospital.
CHA provides state and federal representation and advocacy in the legislative and regulatory arenas to improve access to quality, cost-effective home health care services.
Home health (HH) agencies paid under Medicare’s prospective payment system (PPS) will see a 1.05 percent decrease in payments in calendar year (CY) 2014 as compared to CY 2013 under a final rule released by the Centers for Medicare & Medicaid Service (CMS). The decrease reflects the combined effects of an increase in the home health market basket update percentage of 2.3 percent, offset by a rebasing adjustment of negative 2.7 percent as required by the Affordable Care Act (ACA), and a .62 percent decrease due to a refinement of the HH PPS Grouper. The ACA requires CMS to begin phasing in rebasing adjustments to the national, standardized 60-day episode payment rate, the national per-visit payment rates and the non-routine supply conversion factor to reflect changes since the inception of the HH PPS. For hospital-based facilities, CMS estimates the reduction will be smaller, negative .58 percent, for CY 2014.
The U.S. House of Representatives Ways and Means Committee has released draft legislation that includes several provisions affecting payment policy for post-acute care (PAC) services. The committee held a hearing on the topic on June 14.
The latest legislative proposals mirror PAC proposals put forth by President Obama in his FFY 2014 budget, as well as discussions by Simpson-Bowles and the Bipartisan Policy Commission. The committee’s draft legislation specifically addresses the following changes:
Reducing market basket updates for home health agencies, skilled nursing facilities (SNFs), inpatient rehabilitation facilities (IRFs) and long-term care hospitals;
Creating site-neutral payments between IRFs and SNFs for certain procedures;
Modifying the criteria required for IRF status (the so-called “75 percent rule”);