CMS releases proposed home health payment rule for 2020: 7 takeaways

CMS released its proposed Home Health Prospective Payment System rule for 2020, which would increase home health payments and remove one quality measure from the Home Health Quality Reporting Program.

Seven takeaways from the proposed rule:

1. Under the proposed rule, net home health payments would increase by 1.3 percent, or $250 million, in 2020.

2. The proposed rule sets forth the implementation of the Patient-Driven Groupings Model, a new case-mix methodology that was finalized last year.

3. CMS will stop using the number of therapy visits provided to determine home health payments in 2020. Instead, CMS will implement the Patient-Driven Groupings Model, which will reimburse home health agencies based on patient characteristics rather than the volume of therapy visits.

4. Under the proposed rule, therapist assistants, rather than only therapists, would be allowed to provide therapy. "This proposed change would be consistent with regulations for skilled nursing facilities where therapist assistants can perform maintenance therapy; would allow therapist assistants to practice at the top of their state licensure; and would provide HHAs the flexibility to use either therapists or therapist assistants to meet the maintenance therapy needs of their patients," CMS said in a fact sheet about the proposed rule.

5. The proposed rule would remove one pain-associated quality measure from the Home Health Quality Reporting Program. CMS said it is proposing to eliminate the Pain Interfering with Activity Measure to "mitigate any potential unintended, over-prescription of opioid medications inadvertently driven by these measures." The proposed rule would also remove a question regarding pain communication from the HHCAHPS Survey.

6. Under the proposed rule, CMS would adopt two new quality measures that assess the transfer of health information.

7. CMS will accept comments on the proposed rule through Sept. 9.

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