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CHA DataSuite Releases Analysis of CY 2023 Medicare Home Health PPS Proposed Rule

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CHA DataSuite has issued a hospital-specific analysis of the calendar year (CY) 2023 Medicare home health (HH) prospective payment system (PPS) proposed rule.  

The analysis is intended to show providers how Medicare fee-for-service (FFS) payments will change from CY 2022 to CY 2023 based on the policies set forth in the proposed rule. A detailed summary of the proposed rule is available for CHA members. Comments on the proposed rule are due to the Centers for Medicare & Medicaid Services (CMS) by Aug. 16 and can be submitted electronically.  

The proposed rule includes updates to the Medicare FFS HH PPS payment rates based on changes set forth by CMS and those previously adopted by Congress. Among the proposed updates are:  

  • Recalibration of the Patient-Driven Grouping Model (PDGM) case-mix weights, low utilization payment adjustment 
  • Payment adjustments to reflect the impact of differences between assumed behavior changes and actual behavior changes on estimated aggregate payment expenditures under the HH PPS 
  • Creation of a permanent 5% cap on wage index decreases 
  • Updates to the expanded HH Value-Based Purchasing Program 
  • Updates to the HH quality reporting program 
  • Updates to home infusion therapy rates 

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