In recent news, the U.S. Centers for Medicare & Medicaid Services (CMS) has released its proposed payment rule for home health services for Fiscal Year 2025. The rule indicates that providers may face additional cuts in the near future to achieve budget neutrality and address issues with the Patient-Driven Groupings Model (PDGM).
Specifically, CMS is suggesting a permanent prospective adjustment of -4.067% to the home health payment rate for 2025. This adjustment takes into account differences between expected and actual changes in expenditure due to the implementation of PDGM in 2020. Additionally, there will be a 2.5% payment update for home health services in 2025, which is offset by a 3.6% decrease related to PDGM rebalancing and a 0.6% decrease reflecting a proposed fixed dollar loss.
Overall, CMS estimates that Medicare payments to home health agencies in 2025 will decrease by about 1.7% or $280 million compared to 2024 levels. However, it’s important to note that this situation is still evolving, and further updates on this matter will be provided in the coming days.