New CMS Rule Encourages Home and Community-Based Care for the Elderly and Disabled

WASHINGTON, DC — The Partnership for Quality Home Healthcare — a national coalition representing more than 1,500 community- and hospital-based home health agencies nationwide — today praised the Centers for Medicare & Medicaid Services (CMS) for finalizing the Community First Choice Option, a new program which encourages states to boost participation in home and community-based services (HCBS) among their Medicaid populations. The rule provides states with incentive payments to better utilize HCBS care rather than more expensive, institutional care settings.

This unique program will allow patients, who would otherwise require care in an inpatient setting, to receive services in their own home. Beneficiaries will be eligible to receive skilled home healthcare services and enjoy increased control over their care plan. The program supports increased care coordination and smoother care transitions to the home to help ensure patients are receiving the most clinically appropriate care for their individual needs.

“The Community First Choice Option is an excellent example of how we can and should be encouraging the use of home health among populations that can benefit the most,” stated Chairman Billy Tauzin, senior counsel to the Partnership for Quality Home Healthcare. “Increased patient access to home healthcare services that can improve care and quality of life, while also reducing taxpayer costs, is the right approach.”

States opting to participate in the Community First Choice Option will receive a six percent increase in their Medicaid match rate, known as the federal medical assistance percentage (FMAP). States must meet several requirements in order to qualify for the increased match in Medicaid funds. These requirements include developing the benefit with stakeholders, including members of the senior and disabled communities, and maintaining a quality assurance system specific to the benefit and regularly reporting information to CMS.

“We applaud CMS for giving states positive incentives to keep patients in their homes and we look forward to working with CMS and individual states as they begin to implement the Community First Choice Option,” added Tauzin. “By allowing the senior and disabled communities to have a greater role in their own care, we can more effectively deliver comprehensive care while maintaining high quality standards.”

Skilled home healthcare is clinically advanced, cost-effective and patient preferred. Nationwide, millions of Medicare and Medicaid beneficiaries receive skilled home healthcare services to treat illnesses related to acute, chronic or rehabilitative needs.