CHA News Article

CMS Issues Home Health PPS Final Rule

The Centers for Medicare & Medicaid Services (CMS) has issued the attached home health prospective payment system final rule for calendar year (CY) 2016. CMS projects the overall impact of the rule will be a $260 million (estimated 1.4 percent) decrease in payments to home health agencies as compared to CY 2015. In addition, the rule finalizes updates to the home health quality reporting program, including the implementation of one standardized cross-setting measure as required by the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014.

CMS also finalizes its proposal for a home health value-based purchasing (HH VBP) model in all home health agencies in nine states, not including California. Under this initiative, home health agencies will compete on value and have their payments adjusted downward or upward based on performance related to selected measures. CMS states the HH VBP will test whether incentives for better quality care can improve outcomes in the delivery of home health services. Payment and policy changes will be effective Jan. 1, 2016 unless otherwise noted.