Withdraw the Proposed Home Health Grouper Model

Included in the Centers for Medicare and Medicaid Services (CMS) Proposed Rule for the Home Health Agency (HHA) Prospective Payment System for calendar year 2018 is a policy that will dramatically alter the payment structure for home health services under Medicare starting in 2019. According to CMS’s own estimates, the proposed rule will result in a cut of nearly $1 billion annually. This accounts for approximately five percent of the annual Medicare spending on home health. Simply put, if implemented, this could be a devastating payment model.

The proposal, the Home Health Groupings Model (HHGM) will cause disruption to home health providers nationwide. This payment model is completely untested so its impact on patients and home health agencies is unpredictable. However, reducing Medicare payments by nearly $1 billion annually can only trigger problems in accessing and delivering care. Patients will likely lose access to home care as providers will be paid less than the cost of care. CMS should withdraw this proposal and work with stakeholder groups to ensure that a new model is developed and implemented thoughtfully, without hindering access to care.

Read More Below:

Senate Letter to Price Verma on HHGM

NAHC HHGM Comments

HHGM proposed rule comments

HHGM fact sheet

Past Projections of HHA Behavioral Adjustments Have Been Wholly Wrong

CMS Legality letter

History of Cuts

Dobson DaVanzo briefing