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CHA DataSuite Releases Analysis of Final Rule on Home Health PPS

This post has been archived and contains information that may be out of date.

CHA DataSuite has issued hospital-specific analyses intended to show providers how Medicare fee-for-service payments will change from calendar year (CY) 2018 to 2019 based on the CY 2019 Medicare home health prospective payment system final rule. 

Beginning in CY 2020, the Centers for Medicare & Medicaid Services will adopt a new case-mix adjustment methodology — the Patient-Driven Grouping Model (PDGM) — in place of the current Home Health Resource Groups. The estimated change to home health prospective payment system payments, if the PDGM was implemented today, is shown in the analysis.

The analysis also provides a report that breaks down the current 60-day episodes and the new PDGM 30-day periods into PDGM clinical classifications for comparison, using CY 2019 data. The episodes/periods are classified into one of two admission source categories; assigned as either a first or subsequent 30-day period; classified into one of 12 clinical groupings; given a functional level of low, medium or high; and assigned a comorbidity adjustment.

More information is available in the attached analysis description.