CMS releases home health final rule for CY 2018

The Centers for Medicare & Medicaid Services today released the final rule for the home health prospective payment system for calendar year 2018. For CY 2018, the rule decreases net HH payments by 0.4 percentage points, or $80 million, relative to CY 2017. This includes a 1.0% update to current rates, as mandated by the Medicare Access and CHIP Reauthorization Act of 2015; a 0.5% reduction due to the sunset of the rural payment add-on; and the third and final 0.97 percentage point cut for estimated case mix growth from CYs 2012 through 2014 that the agency states was unrelated to increases in patient acuity. In addition, as urged by the AHA, CMS did not finalize the major modifications to the PPS, called the home health groupings model, that it had proposed to make effective Jan. 1, 2019. Instead, the agency stated that it will further engage with stakeholders in moving toward a revised payment system. "We are pleased that CMS did not implement the HHGM, and will instead take additional time to consider this complicated model and its effect on patients and providers,” said AHA Executive Vice President Tom Nickels. CMS also finalized several changes to the HH Value-Based Purchasing program by raising the minimum number of cases required and removing one measure from the program. For the HH Quality Reporting Program, CMS will adopt two new measures while removing 247 data elements from 33 Outcome and Assessment Information Set items. Lastly, as with the other post-acute payment rules, CMS significantly scaled back its proposal to add a number of standardized patient assessment data to the program. AHA members will receive a Special Bulletin with more information.