CMS Releases Proposed 2016 HHPPS Update

CMS released the FY 2016 Medicare Home Health Payment Rule on July 6.  The proposal includes the following:

  • Year 3 of the 4-year phase-in of HHPPS rebasing required by the Affordable Care Act.  This reduces the episode base payment by $80.95.
  • Market Basket Index (MBI) update of 2.9%, offset by 0.6 productivity adjustment, which leaves the update at 2.3%.
  • Case-mix creep adjustment of 1.72%, which is factored into the MBI adjustment.
  • Recalibration of case mix weights.
  • Proposed episode base rate of $2938.37, down from 2015 base rate of $2,961.38.
  • Net impact of rate changes is a reduction of 1.8%, or $350 million less in payments to home health agencies in 2016.
  • Implementation of a mandatory Value-Based Purchasing Pilot in 9 states in each region of the country.  Massachusetts was randomly selected in New England, but the state selection could change with further data analysis.

 

CMS will host an Open Door Forum about the proposal on Wednesday, July 8 at 3:30pm. Click here for participation details.

 

The HHPPS Update will be published in the Federal Register on July 10. Comments may be submitted to CMS by September 4th.  The Association will rely on guidance from NAHC and VNAA, along with input from our members, before submitting comments.

 

Here is an excellent initial overview of the proposed rule by Bill Dombi, NAHC’s VP of Law.