CMS Proposed Payment Cut to Home Health Agencies






 Part of the reason for the decrease is attributed to a permanent adjustment in behavior assumptions.

The 2024 Home Health Prospective Payment System Rate Update proposed rule released on June 30 revealed that Home Health Agencies will experience a 2.2% payment decrease in 2024 compared to 2023, partly due to a permanent behavior assumption adjustment. CMS issued a 2.7% payment increase for 2024, but this was offset by a 5.1% decrease in permanent behavior assumption adjustment and another 0.2% decrease due to the fixed-dollar loss ratio, as per the statute.

CMS found that Medicare paid more under the new system than it would have under the old system, using updated 2022 claims and the methodology finalized in the 2023 final rule. As a result, CMS is proposing an additional permanent adjustment percentage of -5.653% in 2024 to address the differences in aggregate expenditures.

WHY THIS MATTERS

The proposed rule suggests a permanent, prospective adjustment to the CY 2024 home health payment rate to account for the impact of the implementation of the Patient-Driven Groupings Model (PDGM). This adjustment aims to address the differences between assumed behavior changes and actual behavior changes on estimated aggregate expenditures due to the implementation of the model and 30-day unit of payment as required by the Bipartisan Budget Act of 2018.

https://www.allzonems.com/cms-proposed-payment-cut-to-home-health-agencies/

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