CMS Proposes $80 Million Cut in Home Health PPS Payments for 2018

Posted: Aug. 1, 2017

CMS is proposing to cut CY 2018 Medicare home health prospective payment system (HH PPS) payments by 0.4% — or $80 million overall — compared to 2017 rates under a proposed rule published on July 28, 2017, Reed Smith LLP reports. Furthermore, the agency plans major revisions to the HH PPS case-mix methodology for 2019 that potentially could cut payments by as much as $950 million (-4.3%) in 2019.

CMS will accept comments on the proposed rule until September 25, 2017.

The proposal included the home health groupings model (HHGM)—a model home health care companies see as a threat and a major upheaval to business operations, Home Health Care News reported. Amedisys (Nasdaq: AMED) CEO Paul Kusserow had some fighting words to say about the new groupings model during the company’s earnings call Thursday morning: “Please also remember, it ain’t over until it’s over.”

The groupings model eliminates any incentive for home health care agencies to provide more therapy that comes with higher reimbursement rates. Kusserow expressed worry that doing away with these high reimbursement rates will effectively push home health care providers away from caring for higher acuity patients. The move is in opposition to health care system initiatives that have enabled home health care providers to care for higher acuity patients since the implementation of the Affordable Care Act (ACA).

The Home Care Association of Colorado is offering a 90-minute webinar on the topic with Melinda Gaboury, one of the nation's leading experts on the complexities of home health payment, for this 90 minute webinar. 

Ms. Gaboury is the CEO of Healthcare Provider Solutions, which provides financial, reimbursement, clinical and cost reporting services to the home care, hospice and rehabilitation therapy industries.