(Story updated with comment at 11:15 a.m. ET, Friday, June 28.)
A series of rebasing and coding adjustments from the CMS would cause home health agencies to see a 1.5% reduction in their Medicare payments for 2014, which the CMS estimates could lower total payments to these facilities by $290 million next year.
In a proposed rule Thursday, the CMS said the decrease reflects a 2.4% home health payment update amounting to a $460 million increase in overall payments, combined with a host of adjustments that would decrease payments by $750 million.
The National Association for Home Care and Hospice blasted the proposal, saying it’s based on “an unsupportable calculation” of the differential between home care providers’ costs and revenue. The trade group’s president, Val Halamandaris, said in a statement that the proposed cut “places 3.5 million Medicare beneficiaries at risk of losing access to care as nearly half of the providers of this vital service would be paid less than the cost of care.”
Among the adjustments is a proposal 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 starting in 2014, the CMS adjust the national standardized 60-day episode rate for home health agencies to account for, among other things, changes in the number of visits in an episode of care and the average cost of providing care per episode.