Excellent news from CMS to boost home health referrals

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Jun, 30 2021

By Home Health Care News

The U.S. Centers for Medicare & Medicaid Services (CMS) on Monday proposed plans to expand the Home Health Value-Based Purchasing (HHVBP) model nationwide by the start of next year. The agency did so in its proposed payment rule for 2022.

In addition to the HHVBP expansion, CMS proposed to increase Medicare payments to home health agencies by 1.7% next year, which equates to a roughly $310 million bump. Last year’s proposed payment rule for 2021 included a 2.6% boost, with the final rule lowering that to 1.9%.

Apart from HHVBP and a standard rate increase, Monday’s proposed payment rule also tweaked the formal home health Conditions of Participation (CoPs) and offered insight into CMS’s plans for future Patient-Driven Groupings Model (PDGM) adjustments.

The CMS Innovation Center developed the HHVBP demonstration — one of the most successful alternative payment models ever — in an effort to create financial incentives for better quality of care. First implemented in 2016, the demo is currently active in nine randomly selected states.

“Homebound Medicare patients face a unique set of challenges and barriers to getting the care they need,” CMS Administrator Chiquita Brooks-LaSure said in a statement. “This proposed rule would streamline service delivery and value quality over quantity – at a time when Americans need it most.”

The CMS Innovation Center under the Trump administration previously revealed its intent to expand HHVBP at the beginning of 2021. Since put into action, HHVBP has resulted in an average 4.6% improvement in home health agencies’ quality scores as well as average annual savings of $141 million to Medicare, according to CMS “[HHVBP] is a great example of how the Innovation Center can design successful models that both improve quality for Medicare beneficiaries and lower costs,” Brad Smith, the center’s former leader, said in January. “Over the past year, we have taken a data-driven approach to assessing all the Innovation Center’s models, and we are excited that HHVBP has met our gold standard for expansion as laid out by Congress.” Read More.