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  NAHC Report: Issue# 2790, 11/16/2015
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CMS Implementation of Home Health Value Based Purchasing Program
Steep Medicare Premium Hike Averted Through Recently Enacted Budget Deal
For Your Information: 2016 Private Duty Home Care Conference
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CMS Implementation of Home Health Value Based Purchasing Program

The Centers for Medicare & Medicaid Services (CMS) is moving along quickly with the January 1, 2016, implementation of the Home Health Value Based Purchasing Program (HHVBP) as outlined in the Final Rule issued as part of the 2016 Home Health Prospective Payment rule. Recently, the National Association for Home Care & Hospice (NAHC) met with CMS officials to discuss a multitude of open implementation issues. Home health agencies in the nine states are anxiously awaiting more detailed information on the pilot program that promises to be the most significant Medicare change since the 2000 implementation of prospective payment.

At this point, there are threshold questions yet unanswered by CMS while the HHVBP is only seven short weeks away. Among the crucial questions in need of response is what home health population data will be used to determine an agency’s baseline performance and performance year score. In the CMS meeting, the question was raised as to whether the OASIS and HHCAPS data from the Medicare Fee-for-Service population would be used in HHVBP or whether the data from Medicare Advantage, Medicaid, and other patients would be included. Currently, Home Health Compare and the Star Rating systems use all such data. The Final Rule indicates that the data from Medicare “enrollees” would be used. Officials at the meeting indicated that it is most likely that the HHVBP data will be confined to Medicare fee-for-service beneficiaries. However, that standard appeared far from certain, particularly given CMS’ current combination of all data in its public reporting on HHAs.

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Steep Medicare Premium Hike Averted Through Recently Enacted Budget Deal
CMS Announces 2016 Medicare Part A and B Premiums and Deductibles

The significant budget agreement that was recently enacted into law following negotiations between Congress and President Barack Obama (see previous NAHC Report article here) reduced the steep increase in Medicare Part B premiums that would have otherwise gone into effect. Medicare Part B premiums were previously scheduled to increase by approximately 50 percent starting next year for more than 15 million individuals, or 30 percent of Medicare beneficiaries—those not protected by the “hold harmless” provision (see previous NAHC Report article here).

The “hold harmless provision” under federal law protects 70 percent of Medicare beneficiaries from any Medicare premium increase that exceeds the annual increase in an individual’s Social Security benefit. However, 30 percent of Medicare beneficiaries are not held harmless—those eligible for both Medicare and Medicaid, individuals with incomes over $85,000 annually, new enrollees, and those who do not receive Social Security. Prior to the budget agreement, those affected beneficiaries would have seen their premiums increased from $105 to $159 per month in 2016.

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2016 Private Duty Home Care Conference

At the Private Duty Home Care Conference, you’ll participate in education sessions on marketing and operations tactics, financial acuity, staff recruitment and retention, and more. You’ll hear from leaders and experts at lectures, roundtables, panel discussions, and more. You’ll learn from success stories and pioneering strategies with statistical analysis, data-driven forecasting, improvement studies, and more. Our conference faculty will guide you through legal and regulatory changes. We value what Private Duty brings to the industry and we support your business achievements.

The Private Duty Home Care Conference will feature one-and-half days of speakers, education sessions, and networking opportunities in charming Charleston, South Carolina where you’ll enjoy special rates at the Doubletree Hotel in the heart of the Market District. Reserve your room now to take advantage of our special low rate of $159 while rooms are still available.

This conference is where you can get real solutions to real issues. So, together we can make real progress.

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