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Questions Arise in Light of New Home Health Payment Policies

Posted on Friday, February 16, 2018 5:06 PM

The Bipartisan Budget Act of 2018, which was recently signed into law, is changing how Medicare will pay for therapy going forward.  The law also included a new home health payment model which could  possibly eliminate the use of therapy thresholds in case mix adjustment factors for calculating payments under the prospective payment system (PPS). 

How the model will ultimately look after it is proposed by CMS is unknown—including what the impact on therapy will be.

Providers and industry advocates are also taking a close look at the behavioral adjustments in the new payment model. The behavior adjustments generally refer to the changes that CMS anticipates home health care agencies will make when dealing with new policies.

“The big caveat here is that there is a lot for CMS and the industry to work through,” Des Varady, CEO of industry consulting firm The Corridor Group, told HHCN.

The elimination of the therapy caps in reimbursement calculations is also “something that the industry has been advocating for in certain ways for years,” Varady said.

“The direction CMS is taking in removing therapy visits as a reimbursement cap is the right one, and one the industry agrees with,” Varady said.”

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About Corridor

Corridor is a trusted home health and hospice consulting partner to agencies both large and small. We provide the most up-to-date comprehensive homecare industry educational resources and consulting available.

We specialize in delivering better revenue cycle management solutions, coding and documentation review services, regulatory compliance, and healthcare consulting.

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