The Centers for Medicare & Medicaid Services (CMS) has released its proposed rule for the home health prospective payment system for calendar year 2025. This rule is expected to result in a reduction of net home health payments by an estimated $280 million, or -1.7%, compared to the current year.
The update includes a 3.0% market basket update, but this will be reduced by a 0.5% productivity adjustment. Additionally, CMS is proposing to decrease the base payment rate by 4.1% due to the implementation of the Patient-driven Groupings Model, which will ultimately reduce total payments by 3.6%.
The American Hospital Association (AHA) has expressed concerns about these adjustments, especially given previous downward payment adjustments in recent years. The AHA also worries that these changes could negatively impact patient care and access to services.
Furthermore, CMS plans to revise infection prevention and control requirements for long-term care facilities. This includes extending reporting to the Centers for Disease Control and Prevention of a subset of current COVID-19 data elements and requiring reporting for data related to influenza and RSV to begin on January 1, 2025.
In addition to these changes, CMS is also proposing new standards for HHAs related to accepting patients for service. While no quality measures are being added or removed from the HH Quality Reporting Program, CMS is proposing to adopt and modify certain patient assessment items related to health-related social needs.
Comments on the proposed rule will be accepted by CMS through August 26th
