July 26, 2017

Home Health Leaders Urge Collaboration with CMS to Refine Proposed Home Health Groupings Model in HHPPS Proposed Rule

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The Partnership for Quality Home Healthcare — a coalition of home health providers dedicated to developing innovative reforms to improve the program integrity, quality, and efficiency of home healthcare for our nation’s seniors — urged the Centers for Medicare & Medicaid Services (CMS) to work collaboratively with the home health provider community to address the significant flaws in the Home Health Groupings Model (HHGM) as proposed in the Home Health Prospective Payment System (HHPPS) Proposed Rule that was released yesterday.

As early as 2019, CMS proposes to implement the HHGM, a payment reform approach that dramatically alters Medicare payment for skilled home health services. In response to yesterday’s proposed rule, the Partnership plans to release an analysis of the proposed payment model and its impacts on home health delivery. Further, the Partnership expects to work with CMS on broad based payment reforms to refine the proposed payment system and improve the delivery of care for the 3.5 million Medicare beneficiaries who depend on the home health benefit.

“CMS is proposing a major reform to home health reimbursement without having worked collaboratively with industry partners like the Partnership and we expect to be included in payment reform development going forward,” said Keith Myers, Chairman of the Partnership. “We question whether CMS has the unilateral authority to make such a proposed change without action by Congress.”

While the Affordable Care Act directs the Secretary of Health and Human Services (HHS) to conduct a study to examine the costs of treating high risk patients to ensure ongoing access to care for home health beneficiaries, the Partnership is concerned that the model developed by the previous Administration would create access to care issues for Medicare’s vulnerable home health patients and result in disproportionate cuts for certain high-quality providers if implemented as originally drafted.

“The Partnership anticipates CMS will use the year ahead to fix this proposed payment model or develop more broad based alternatives by working with experienced, high quality providers to ensure policies are put in place that protect both patients and compliant providers,” added Myers. “We strongly encourage a thoughtful and more transparent process in working more collaboratively with the provider community and other concerned stakeholders on Medicare payment reform.”

The Partnership will continue to analyze the proposed rule in more detail and provide comments and recommendations to CMS to protect access to care for Medicare’s vulnerable home health beneficiaries. The Partnership is committed to working with CMS to create a better, stronger, and more financially responsible payment model for the home healthcare industry.