CHA News Article

CMS Updates Home Health PPS Payments
Reimbursement cut by 1.05 percent from CY 2013

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 rule also finalizes the addition of two new claims-based quality measures while reducing the overall number of quality measures currently reported. The two new measures — re-hospitalization during the first 30 days of a home health stay and emergency department use without hospital readmission during the first 30 days of home health — are not currently endorsed by the National Quality Forum and were opposed by CHA in comments. CHA will prepare a more detailed summary for members in the coming weeks. The final rule is attached and is effective on Jan. 1, 2014.