CMS Proposed Home Health Payment Rates for 2014

Late last week the Centers for Medicare and Medicaid Services (CMS) released the proposed payment rates for FY2014. The proposal includes rebasing as well as significant changes in case mix weights. According to CMS, the changes will result in an overall payment reduction of 1.4% in 2012. William A. Dombi, the Vice President for Law at the National Association for Home Care and Hospice (NAHC) held a conference call last Friday, June 28 to discuss NAHC’s initial reaction to the proposal. According to Mr. Dombi, “The proposal sets the rebasing impact at the maximum of 3.5% based on a projected differential of 13.63% between episode revenue and episode cost projected for 2013. This is at extreme odds with 2011 data that shows a margin of 11.25%.NAHC’s calculation is based on over 9000 cost reports from 2011 while the CMS calculation is based on 6225 reports including freestanding and hospital based HHAs.”

These proposals would change the base rate to about $2860 as compared to the current $2137 rate. However, with the case mix weights recalibrated to a 1.0 starting point, the base rate combined with across the board lower case mix weights would result in a net payment decline.

NAHC is just beginning to review the proposal and has already requested a meeting with CMS to gain a better understanding. Go to the NACH website for more information.

Quality In Real Time is also currently reviewing the proposal and will be formulating official comments which will be sent to CMS. All agencies and providers are encouraged to review the proposed changes and submit comments. Instructions for comment submission can be found within the proposal which can be found at CMS-1450-P.

If you have any questions or would like more information regarding QIRT, please contact us.

Until next time,

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