Monday, September 25 | Legislative/Policy, Post-Acute Care
If you’ve been keeping up with the latest in the home health industry this year, you’ve most definitely heard the term Home Health Groupings Model (HHGM) floating around at one point or another. Since the introduction of the home health prospective payment reimbursement model, the HHGM is a significant and controversial proposal, shaking up the home health industry.
So what does this new payment model proposal mean for you, your organization and the industry? In this three-part blog series, we’ll explore what HHGM is and what it entails, the impact and reaction from the home health industry as well as what it means for the future of home health.
During the summer of 2017, the Centers for Medicare and Medicaid Services (CMS) shook up the home health industry and unveiled the HHGM while proposing updated payment rates and wage indexes for calendar year (CY) 2018. Due to take full effect in CY 2019, the redesigned payment system is expected to uphold CMS’s desire to move from reimbursement for quantity to reimbursement to quality of care by removing therapy visits as a factor in payment determinations. Additionally, CMS wants to make a shift toward compensating complicated, higher acuity cases more appropriately.
Many home health providers deliver therapy visits as a core portion of the 60-day plan of care. Changes to the payment implications based on therapy need, the reduction to a 30-day episode, and other areas of the payment model worry providers about their long-term stability.
Significant changes to the current payment model include:
The rule is a complete turnaround from what was originally proposed at the beginning of 2017, creating a feeling of frustration within the industry. CMS holds firm that the HHGM rule is in alignment with broader goals to help alleviate provider stress, support the relationship between patients and doctors, as well as promote clarity, flexibility and advancement in care delivery.
Beyond the HHGM, there are additional factors going on in home health reimbursement that are expected to add additional strain to financial worries:
Between the proposed HHGM and other reimbursement reductions forecasted for the future, there’s no doubt of the concern and nervousness in the home health community. Working with limited resources already, the proposed changes are surfacing a lot of stress and concerns for many providers.
Join us next time for part two of our series where we’ll dive deeper into industry reactions to the new payment model and examine the impact that may result from the proposed changes.
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In today's rapidly evolving healthcare landscape, managing the cost of care and improving patient outcomes are crucial priorities. To address these challenges, value-based reimbursement has emerged as a widely embraced approach. This system focuses on optimizing healthcare services while managing expenses. At the core of this strategy lies value-based contracting, a payment model that aims to align provider reimbursement with the outcomes achieved by patients. By incentivizing quality care and efficient resource utilization, value-based contracting promotes a more coordinated and effective healthcare system.
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