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Insights

Updates Regarding the Much-Anticipated Home Health Proposed Payment Rule for 2018 & HHGM

Posted on Wednesday, July 26, 2017 8:57 PM

The industry was waiting for the Home Health Proposed Payment rule for 2018 and an update on the Home Health Groupings Model also known as HHGM. After a number of delays, information on both was released by CMS yesterday afternoon. The larger headline is that embedded inside of the HH Proposed Payment Rule is that CMS is looking to implement the HHGM in January 2019.

The HH Proposed Payment for CY (Calendar Year) 2018 (CMS-1672-P)  was unveiled with a proposed cut of 0.4% to HHA’s for 2018. This is less than the 0.7% cut that was implemented last year.

For CY 2019 payments, CMS proposes to implement an alternative case-mix adjustment methodology, the Home Health Groupings Model (HHGM). The HHGM would use 30-day episodes, rather than 60-day episodes, and rely more heavily on clinical characteristics and other patient information (e.g., principal diagnosis, functional level, comorbid conditions, referral source, and timing) to place patients into various payment categories.

For the HH Quality Reporting Program (QRP), CMS is proposing to adopt for the CY 2020 payment determination three measures to meet the requirements of the IMPACT Act and new standardized data elements. To reduce provider burden, CMS is proposing to remove or modify current OASIS items. CMS is also proposing processes for requesting reconsideration of determinations regarding compliance with pay-for-reporting requirements, as well as a process for providing exceptions to these policies and extensions to reporting timeframes. Lastly, CMS is also proposing changes to the Home Health Value-Based Purchasing (HHVBP) Model.

CMS will be accepting open comments www.regulations.gov on the HH Proposed Payment Rule and HHGM until September 25, 2017. While this is not final rule, the impact to agencies that provide Home Health services needs to be absorbed and evaluated.

For additional updates, please review our Insights page on a regular basis.

Written by Mary Morrisey-Gabriel, Corridor’s Vice President of Marketing & Innovation

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