The Centers for Medicare & Medicaid Services (CMS) is scheduled to release the final rule for home health agencies at the end of the month. This is a highly anticipated event, as the rule will outline significant changes to the way home health agencies are reimbursed and regulated.
While we don't know the specifics of the final rule yet, it is anticipated that it will follow the general structure of the proposed rule released in June. Based on this, we can expect it to address the following areas:
What to Expect in the CMS CY2024 HH Final Rule
- Reimbursement Updates: While it is possible that the extent of the reduction may be softened, CMS is expected to follow through with the implementation of its permanent behavioral adjustment to the Medicare PDGM base rates. This would represent cuts in global reimbursement as a continued phase-in of CMS’ behavioral adjustments under PDGM.
- Case Mix Recalibration: As part of its annual process, CMS is expected to make updates to the case-mix components of the Medicare PDGM rates to account for trends identified under the reimbursement model. This could include changes to the calculations for functional scoring and comorbidity adjustments.
- Value-Based Purchasing (VBP): Agencies should expect further updates to the Home Health VBP program revisions included in the proposed rule. The most notable of these is the transition to a “potentially preventable hospitalizations” measure.
- Quality of care: CMS is also focused on improving the quality of care in home health. The proposed rule is likely to include new requirements for quality reporting and performance improvement.
Ensuring Success No Matter the Final Rule Outcome
Home health agencies should stay tuned for the release of the final rule and begin preparing for the changes that it will bring. In the meantime, you can take the following steps to ensure your agency is well-positioned for the future:
- Review current operations and identify areas for improvement.
- Analyze key agency costs to uncover opportunities to mitigate anticipated rate cuts without significantly impacting operations.
- Explore new revenue streams and payor relationships to diversify your payor mix.
- Develop a plan to implement the changes that are outlined in the final rule.
- Invest in training and education for staff.
- Work with partners, such as CMS and other home health agencies, to advocate for policies that support the home health industry.
- Outsource processes when you can so that your clinical staff can focus on what matters most – patient care.
We will provide a detailed overview of the rule and discuss its implications for home health agencies.
How SimiTree Can Help
SimiTree can help you implement all coming changes. Need help understanding the impact of the 2024 final rule on your agency? Our consultants at SimiTree can develop individualized work plans or performance improvement projects (PIPs) to help you implement the changes effectively.
We’re also available for staff training (on-site or online and personalized to meet your needs) to make certain your team is ready to operate at peak performance in 2024. Use the form below to contact us and let us know how we can help you thrive or call us today at 866.839.5471. If you prefer to email us, send us any questions at firstname.lastname@example.org. We look forward to helping you!