CHA News

Final Home Health Rule Reduces Impact of Behavioral Adjustments on Providers

What’s happening: The Centers for Medicare & Medicaid Services (CMS) has issued the final rule for the home health prospective payment system for calendar year 2024.  

What else to know: Medicare payments to home health agencies will increase in the aggregate by 0.8% instead of the 2.2% decrease that was originally proposed.  

CMS notes that many commenters expressed concern about the magnitude of a single-year implementation of the required adjustment, which was for changes in provider behavior associated with the implementation of the patient drive grouping model in 2020. As a result, CMS is finalizing roughly half of the full permanent adjustment projected.   

CMS also finalizes several proposals to rebase and revise the home health market basket and to update payment and policy, including the establishment of regulations to implement payment for items and services related to two new benefits: lymphedema compression treatment items and home intravenous immune globulin. The final rule also includes updates to the home health quality reporting program and changes to the expanded home health value-based purchasing model.   

CHA is providing the attached summary, prepared by Health Policy Alternatives, Inc., of the provisions of the final rule, which take effect Jan. 1, 2024.