PDGM. Here we go!

CMS issued its final rule for the 2020 payment model, PDGM, on October 31. It included rates of payment that go into effect on January 1, 2020. The final rule offered some minor tweaks to the payment model and set out 2020 payment rates. The rule includes a 4.36 percent cut (which CMS refers to as a “behavioral adjustment”) to home health rates. The cut is meant to offset changes CMS expects home health agencies to make in response to the new model. The rule proposed in July set the cut at 8.01 percent.

Our national partner the National Association of Home Care and Hospice (NAHC) opposes the cut and has sought federal legislation to stop it. Both Sen. Shaheen, Jeanne [D-NH]* and Sen. Hassan, Margaret Wood [D-NH have signed onto companion bills that would require CMS to hold any adjustments until after the model has been implemented and there is data to review, instead of making prospective guesses.

The final rule also included other adjustments affecting home health, including:
• a 2021 home infusion therapy benefit
• quality measures
• the Home Health Value-Based Purchasing Demonstration program

After CMS Issues Final PDGM Rule, Advocates Ask: “What Now?”

Washington, D.C. (November 6, 2019)-Days after the Centers for Medicare & Medicaid Services (CMS) issued its final rule governing the new payment model for home health care, industry advocates are asking for guidance from the community on what to do next.