Last week CMS announced it’s final rule regarding reimbursement changes in the Medicare home health care management prospective payment system (HH PPS) for the upcoming 2015 year. These changes will ultimately reduce payments to home agencies by .3%, or roughly $60 million dollars.
Nationwide, approximately 12,000 home health agencies provide service to 3.5 billion patients and have billed Medicare around $18 billion dollars (based on 2013 figures). The reimbursement changes follow the timeline of the ongoing four-year rate adjustments for standard 60-day episodes. Additionally, per-visit payment rates will be increased and the NRS (non –routine medical supplies) conversion factor will be reduced. In 2015 the standard 60-day episode rate will be updated to $80.95 and the 60-day episode payment will be $2,961.38
CMS has remarked in a written statement that these changes will “foster greater efficiency, payment accuracy, and improved quality”. The new ruling is just one of many rules for 2015 that have been implemented by the administration for the purpose of providing higher quality of care and payment strategies.
CMS has also remarked:
“Provisions in these rules are helping to move our health-care system to one that values quality over quantity and focuses on reforms such as measuring for better health outcomes, focusing on disease prevention, helping patients return home, helping manage and improve chronic diseases, and fostering a more-efficient and coordinated health care system”
The upcoming changes reflect the newly introduced Value-Based Purchasing (VBP) model that aims to provide incentives for higher quality of care. MH
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