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Home health agencies will see a smaller cut in their fiscal 2014 Medicare payments and other news


By Modern Healthcare
Posted: November 23, 2013 - 12:01 am ET
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Home health agencies will see a smaller cut in their fiscal 2014 Medicare payments than the CMS signaled in its draft regulation. In a final rule issued Friday, the CMS said home health providers will see a 1.05% reduction for 2014, which the agency estimates will amount to a $200 million hit to the sector next year. The CMS previously proposed a 1.5% cut. Officials noted the reduction is also “notably” less than the 4.89% reduction in payments to home health providers in fiscal 2011. The final rule retains, however, a plan to reduce the national standardized 60-day episode rate of 3.5% each year between 2014 and 2017. The Patient Protection and Affordable Care Act requires that the CMS adjust the national standardized 60-day episode rate for home health agencies to account for variables such as changes in the number of visits in an episode of care and the average cost of providing care per episode. The regulation also imposes new quality measures requiring home health providers to report rates of unnecessary hospital readmission and preventable trips to the emergency room.

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A legislative panel put forward three options for the future of the Medicaid program in Utah—and full expansion is not one of them. Under the healthcare overhaul law, the federal government would pick up the full cost of Medicaid expansion through 2016 and 90% after that. But Gov. Gary Herbert and other Republican leaders in Utah have been reluctant or resistant to take up the offer. The panel's recommendations are designed to help the Legislature decide during the next session, and Herbert is doing his own research and plans to make a decision next year. In addition to recommending lawmakers consider leaving Utah's Medicaid program as is, the panel suggested two models for partial expansion. The first would offer Medicaid to residents at or below the federal poverty level and leave the rest to get insurance through the new health insurance marketplace, where they would likely get federal subsidies. The other option would call for the state to use Medicaid money to help pay for private insurance for people who earn slightly more than the federal poverty level.


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