Beyond The Cuts: What Else Home Health Providers Need To Know About CMS’ Proposed Rule

Home Health Care News | By Patrick Filbin
When the U.S. Centers for Medicare & Medicaid Services (CMS) published its FY 2024 home health proposed payment rule, the 2.2% cut immediately became the focus.
But the nearly 300-page rule included dozens of other notable, proposed changes to home health care.
From Home Health Value-Based Purchasing (HHVBP) Model tweaks to a more focused approach on health equity, there are a number of developments that home health providers and stakeholders are keeping an eye on.
One of the major changes CMS included in the proposed rule deals with HHVBP.
Most notably, CMS is proposing to remove five quality measures and add three to the applicable measure set starting in 2025.
The three additions are around discharge function scores, discharges to the community and potentially preventable hospitalizations during home health care coverage.
“There are some significant updates to the VBP, not the least of which is the highest measure, which is currently acute care hospitalizations,” Nick Seabrook, managing principal and SVP of consulting at SimiTree, told Home Health Care News. “CMS is changing that now to potentially preventable hospitalizations. This may be the way to help offset that dynamic where, if you’re an agency that is hospital-based, you may have a higher rehospitalization rate because of the nature of the patients you take and their acuity.”
The new potentially preventable hospitalizations benchmark, Seabrook said, is CMS’ way of introducing a new algorithm that will try to level the playing field across the industry.
Another reason why that change is critical for home health providers to pay attention to is the weight of that measure in the overall VBP calculation.
“It’s still being proposed that 26% of your VBP score is weighted towards that one specific measure,” Seabrook said. “If you’re going to focus on any measure on your value-based purchasing measures, it’s going to be that one.”
Another change includes replacing the OASIS-based discharge-to-community measure with the claims-based discharge community post-acute care measure…

Read Full Article