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CHA DataSuite Releases Analysis of Medicare Home Health Prospective Payment System CY 2020 Final Rule

For CFOs, reimbursement directors

This post has been archived and contains information that may be out of date.

CHA DataSuite has issued hospital-specific analyses detailing the Centers for Medicare & Medicaid Services (CMS) calendar year (CY) 2020 Medicare home health (HH) prospective payment system final rule.

This analysis is intended to show providers how Medicare fee-for-service payments will change from CY 2019 to CY 2020 based on the final rule’s policies, as well as payment data from the CY 2020 final rule HH patient driven groupings model (PDGM) outcome and assessment information set (OASIS) limited data set (LDS).

Due to a lack of comparable payment data between the LDS and the CY 2020 published national standardized 30-day episode payment rate, dollar impacts are based on full behavioral adjusted payment rates, including a conservative base 30-day payment rate from the LDS.

Changes modeled in the analysis include the market basket update, Affordable Care Act-mandated productivity reduction, Bipartisan Budget Act of 2018-mandated market basket update, case-mix budget neutrality, wage index budget neutrality adjustment, wage index and labor share change, rural add-on, PDGM, and full behavioral assumption.

The analysis uses the CY 2020 final rule HH PDGM OASIS LDS, which uses 2018 data as its basis and does not estimate the impact of home health agency-level changes due to volume or case-mix. The analysis does not estimate the HH-specific revenue impacts of changes to PDGM weights.

For more information, see the analysis description.