CMS Rebasing Proposal Worries Agency Associations

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Karen Utterback By Karen Utterback 
Former Vice President, Product Marketing and Strategy, McKesson (Retired)

CMS Rebasing Proposal Worries Agency AssociationsThe Partnership for Quality Home Healthcare and the National Association for Home Care and Hospice (NAHC) recently expressed alarm at Medicare funding cuts proposed by CMS. Home health agencies will want to keep a close eye on the next stages of the proposal, as it could have a negative effect on funding in the next few years.

In a draft of the Home Health Prospective Payment System (HHPPS) rule for 2014, CMS proposes the elimination of 170 diagnostic codes and a rebasing rate set at the maximum permitted level.

The Partnership’s analysis shows that the $72.5 billion in cuts already in current law will cause 10 states to experience net Medicare home health losses in the near future and that the 3.5% rebasing proposed would cause all 50 states to experience losses by 2017.

The analysis calls for a reexamination of the data used in creating the proposal (e.g., recent rises in fuel costs were not considered) and questions why a cumulative impact analysis was not conducted (the rule assesses its impact in 2014 alone, but rebasing will be applied for four years starting in ’14).

In its July 31 edition, Home Care Technology Report noted that NAHC attorney Bill Dombi believes NAHC staff can demonstrate to CMS that the proposal doesn’t take important considerations into account that affect rebasing and that the agency will provide more reasonable rebasing figures.

The Partnership has devised its own pro-patient alternative. Its Skilled Home Health and Integrity Program Savings Act includes reforms designed to reduce waste, fraud and abuse. According to The Partnership, the reforms are based on outlier payment reform that was successfully implemented in 2010 and is projected to bring in more than $11 billion in savings over 10 years.

The Partnerships says it looks forward to presenting comprehensive analyses that will demonstrate the risks of the draft as it now stands, and we expect home health agencies to closely follow HHPPS as it enters the next stages.

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