Program Integrity Reforms Work

The Centers for Medicare and Medicaid Services (CMS) recently released data that backs up the Partnership’s position that program integrity reforms in Medicare can result in serious healthcare savings.

In 2009, the home healthcare community proposed a 10 percent cap on outlier payments to Medicare home healthcare providers.  The proposed policy was included in the Patient Protection and Affordable Care Act of 2010 and data has become available for the first time that proves the policy worked.  In fact, it resulted in even greater savings than the home healthcare community original projected.

In just one year, the outlier cap led to a 70 percent reduction in outlier payments, which generated $853 million in Medicare savings!

This new data goes to show that program integrity reforms work.  As Congress reconvenes this month, the Partnership will continue to work with lawmakers to advance more reforms that will strengthen the Medicare program, save valuable federal funding and, most importantly, help protect senior access to healthcare.