{"id":5696,"date":"2018-10-31T14:21:33","date_gmt":"2018-10-31T14:21:33","guid":{"rendered":"http:\/\/tele.healthcare\/?p=5696"},"modified":"2018-10-31T14:21:33","modified_gmt":"2018-10-31T14:21:33","slug":"cms-shifting-home-health-to-value-based-payments-under-new-model","status":"publish","type":"post","link":"https:\/\/drmiltie.com\/at-home-testing\/cms-shifting-home-health-to-value-based-payments-under-new-model\/","title":{"rendered":"CMS Shifting Home Health to Value-Based Payments Under New Model"},"content":{"rendered":"

The finalized Patient-Driven Groupings Model will transition home health agencies to more of a value-based payment system by 2020, CMS announced.<\/p>\n

Medicare will start to reimburse home health agencies under the Patient-Driven Groupings Model (PDGM) in the Home Health Prospective Payment System (HH PPS) by January 2020. The reimbursement model will pay the agencies based on patient characteristics rather than the number of therapy visits.<\/p>\n

\u201cThe PDGM removes the current incentive to over-provide therapy, and instead, is designed to reflect CMS focus on relying more heavily on clinical characteristics and other patient information to allow payments to more closely reflect patients\u2019 needs,\u201d CMS stated in a fact sheet<\/a> on the rule.<\/p>\n

\u201cUsing patient characteristics to place home health periods of care into meaningful payment categories is more consistent with how home health clinicians differentiate between home health patients in order to provide needed services,\u201d the federal agency continued. \u201cThe improved structure of this case-mix system would move Medicare towards a more value-based payment system that puts the unique care needs of the patient first while also reducing the administrative burden associated with the HH PPS.\u201d<\/p>\n

Shifting the Medicare reimbursement system to value-based payments will also save home health agencies (HHAs), CMS added.<\/p>\n

\u201cChanges in data collection under the new case-mix system, coupled with the changes below regarding meaningful measures and the Home Health Quality Reporting Program, will reduce burden for HHAs by approximately $60 million annually, beginning in CY 2020,\u201d the fact sheet stated.<\/p>\n

CMS will also update the home health reimbursement by paying for innovation.<\/p>\n

The final rule on the 2019 HH PPS will also allow home health agencies to report the cost of remote patient monitoring<\/a> as allowable costs on the Medicare cost report form.<\/p>\n

\u201cThis is expected to help foster the adoption of emerging technologies by home health agencies and result in more effective care planning, as data are shared among patients, their caregivers and their providers,\u201d CMS explained in the fact sheet. \u201cThe use of such technology can allow for greater patient independence and empowerment. Supporting patients in sharing their data will advance the MyHealthEData initiative<\/a>, led by Jared Kushner and the White House Office of American Innovation.\u201d<\/p>\n

Other changes to the HHS PPS included in the final rule from CMS included:<\/p>\n

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