06.27.2022

Navigating the Home Health Proposed Rule and Its Impact on Your Agency

CMS wants to decrease Medicare reimbursement for home health by 4.2 percent in 2023, applying a behavioral based reduction in pay that has been widely criticized in the industry as using unproven methodology. The pay decrease was set out in a proposed rule issued June 17 to update the Home Health Prospective Payment System in 2023.

Join SimiTree Principal J'non Griffin and Financial Consulting Director Brian Harris as they team up for a complimentary webinar to review the financial implications of the proposed decrease and discuss strategies agencies should consider for dealing with rising costs and tighter margins. They'll also provide an overview of other significant changes outlined in the rule, including:

  • Extensive recalibration of PDGM case mix weights, including changes to some primary clinical groupings, functional levels and comorbidity adjustment subgroups, and LUPA thresholds.
  • Use of 2022 as the new baseline year for nationwide expansion of the Home Health Value Based Purchasing Model. Previously, CMS had planned to use 2019 as the baseline year.
  • A 5 percent cap on negative wage index fluctuations, mirroring a similar hospice proposal.
  • New G codes for reporting telehealth visits on claims beginning in 2023, although no reimbursement will be allowed.
  • A new quality reporting requirement for the OASIS to be completed for all payers, not just Medicare and Medicaid.

This webinar is scheduled for Thursday, June 30 at 12pm EST. Click here to register for the webinar.

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