Recently, the Centers for Medicare & Medicare Services (CMS) released their CY 2018 proposal for the Health Prospective Payment System (HHPS) and the Home Health Groupings Model (HHGM) within it. This proposal would drastically alter the home health payment system, putting the 3.5 million Medicare beneficiaries that depend on the home health benefit at risk.
The HHGM would overhaul the current Medicare payment system in a non-budget neutral manner. Payments would now be based on patient characteristics instead of care needs, and distributed based on location of providers rather than their quality of service. This causes uneven payment distribution, as high-quality providers in certain areas could face disproportionate cuts. Furthermore, the geographic disparity would have the greatest effect on seniors living in rural, smaller areas, potentially putting their access to care at risk.
The HHGM could be implemented as early as 2019. If implemented as is, it could harm home health patients’ access to quality care and cause disproportionate home health provider payments.
We believe that CMS must work with the home health community in order to properly address and solve the issues within the HHGM. We welcome engagement with CMS, but need more data and information to be able to offer in-depth policy recommendations.
Click here to see our five reasons why CMS and the Home Health Community should work together to improve the HHGM.