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CHA DataSuite Analyses Released: Home Health CY 2020 Proposed Rule, Inpatient Rehabilitation Facility FFY 2020 Final Rule

For CFOs

CHA DataSuite has issued two hospital-specific analyses, one detailing the Centers for Medicare & Medicaid Services (CMS) calendar year 2020 Medicare home health prospective payment system (PPS) proposed rule, and the other detailing federal fiscal year 2020 Medicare inpatient rehabilitation facility (IRF) PPS final rule.

Home Health PPS Calendar Year 2020 Proposed Rule

This analysis is intended to show providers how Medicare fee-for-service payments will change from calendar year (CY) 2019 to CY 2020 based on the proposed rule’s policies. Changes modeled include the market basket update, Affordable Care Act-mandated productivity reduction, Bipartisan Budget Act of 2018-mandated market basket update, patient-driven groupings model case-mix budget neutrality, wage index budget neutrality adjustment, wage index and labor share change, rural add-on payments for episodes and visits ending during CYs 2019 through 2022, and patient-driven groupings model (PDGM).

The analysis uses Outcome and Assessment Information Set (OASIS) PDGM limited data set, with 2018 data as its basis, and does not estimate the impact of home health agency-level changes due to volume or case mix. It also does not estimate the home health-specific revenue impacts of changes to PDGM weights.

The analysis uses the home health wage index data as of May 21, 2019, to be consistent with the OASIS PDGM limited data set and CMS impact file. CMS has provided an updated list of proposed home health wage indices as of June 19, 2019.

For more information, see the analysis description.

Inpatient Rehabilitation Facility PPS Fiscal Year 2020 Final Rule

This analysis is intended to show providers how Medicare fee-for-service payments will change from federal fiscal year (FFY) 2019 to 2020 based on policies set forth in the FFY 2020 IRF PPS final rule.

Payment changes modeled include the market basket update, Affordable Care Act-mandated market basket reductions, budget neutrality adjustments, wage index updates, and case-mix group updates.

Estimated FFYs 2019 and 2020 payments are calculated using individual IRF characteristics (cases, case-mix index, and factors to derive the rural, teaching, and low-income patient adjustments) from the FFY 2020 IRF final rule rate setting file provided by CMS.

The standard payment conversion factors, wage indexes, and labor-related shares are from the FFYs 2019 and 2020 final rule, as published in the Federal Register. The FFY 2019 wage index is from the FFY 2020 proposed rule wage index provider-specific impact file. Wage indexes used in the analysis reflect hospital wage index values without the rural floor or reclassifications.

For more information, see the analysis description.