THE ISSUES

While evidence already confirms that home healthcare is a cost effective care setting with positive clinical outcomes for patients, the Partnership is working to further improve quality and access for the patients we serve.

Supporting Care Delivery During the COVID-19 Public Health Emergency

As our nation continues to confront the COVID-19 outbreak, the home health community is working aggressively to protect patients, home health care providers, and the communities we serve. As the outbreak continues to develop, the Partnership is working with the Administration and Congress to identify actionable measures for expanding home health under current federal regulations and suggesting specific policy changes to address these issues:

  • COVID-19 Waivers and Flexibilities: The current waivers and flexibilities granted by Congress and CMS have helped both home health providers and their patients. The Partnership supports the continued extension of the public health emergency (PHE) and the use of these waivers and flexibilities during 2021 and for expanding and making permanent a number of the waivers.
  • Provider Relief Funds: The provider relief funds allocated under the CARES Act have helped home health agencies during the PHE. The Partnership supports use of these funds for home health providers for assistance with either expenses incurred or lost revenue.
  • Review Choice Demonstration (RCD) for Home Health Services: Due to the continuing public health emergency, the Partnership encourages CMS to delay implementation of these demonstrations until the PHE ends.

To learn more about the home health community’s response to COVID-19, CLICK HERE.

 

Ensuring Appropriate Medicare Payments to Providers

In November 2020, CMS finalized the CY2021 Home Health Prospective Payment System (“HHPPS”) Rule, which included a -4.36% payment rate change to the Medicare home health benefit largely based on behavioral adjustment cuts.

In 2021, the Partnership will continue to pursue a correction of the behavioral adjustments and related -4.36% rate reduction that the Centers for Medicare & Medicaid Services (CMS) applied in establishing payments under the home health prospective payment system (PPS) and Patient Directed Groupings Model (PDGM) for calendar years (CYs) 2020 and 2021.

The Partnership will examine more recent Medicare claims data to determine the accuracy of these adjustments and advocate with CMS, MedPAC, and congressional offices for greater transparency and a corrective adjustment to the rate.

>ISSUE BRIEF: Key Policy Priorities for 2021