NAHC Comments on the Proposed Changes to the Medicare Home Health Prospective Payment System
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Barbara D. Woolley
WASHINGTON, DC (June 28, 2013) The Centers for Medicare & Medicaid Services (CMS) announced on Thursday, June 27, proposed changes to the Medicare home health prospective payment system (HHPPS) for 2014 incorporating rebasing along with changes in case mix weights. CMS proposes to apply the full 3.5% rate cut authorized under the law. This results in an overall payment reduction of $290 million based on projected spending in 2014.
The CMS proposal is based on a projected 2013 differential between cost and revenue (margins) of 13.63 percent. This calculation is at severe odds with calculations by both MedPAC and National Association for Home Care & Hospice (NAHC). Using a larger database than employed by CMS, NAHC estimates the 2013 margin at 8 percent to 9 percent. NAHC is seeking clarifications and a full disclosure of its calculation data and methodology. At this point, NAHC believes that the proposal is based on an unsupportable calculation.
The proposal places the 3.5 million Medicare beneficiaries receiving home care services 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. It is neither fair nor right and needs to be changed, stated Val J. Halamandaris, president of NAHC.
The National Association for Home Care & Hospice (NAHC) is a nonprofit organization that represents the nations 33,000 home care and hospice organizations. NAHC also advocates for the more than two million nurses, therapists, aides and other caregivers employed by such organizations to provide in-home services to some 12 million Americans each year who are infirm, chronically ill, and disabled. Along with its advocacy, NAHC provides information to help its members provide the highest quality of care and is committed to excellence in every respect. To learn more about NAHC, visit www.nahc.org.