On November 1, 2017, CMS released the 2018 Home Health Final Rule. To the delight of home health agencies, the rule was finalized without the implementation of the Home Health Groupings Model (HHGM), which was proposed for roll-out in 2019.

CMS stated, “We are not finalizing the implementation of the Home Health Groupings Model (HHGM) in this final rule. We received a number of comments from the public that we would like to take into further consideration.” HHGM is an alternative case-mix adjustment methodology that would have used 30-day periods, rather than 60-day episodes, and would rely more heavily on clinical characteristics and other patient information (e.g., principal diagnosis, functional level, comorbid conditions, referral source, and timing) to place patients into more meaningful payment categories.

The 2018 home health final rule:

  • Updates the home health prospective payment system (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor, effective for home health episodes of care ending on or after January 1, 2018.
  • Updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking.
  • Implements the third year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity between calendar year (CY) 2012 and CY 2014.
  • Reviews efforts to monitor the potential impacts of the rebasing adjustments that were implemented in CY 2014 through CY 2017.
  • Finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model and to the Home Health Quality Reporting Program (HH QRP).

The regulations are effective January 1, 2018. Click here to read the 2018 home health final rule.

HEALTHCAREfirst will host an upcoming webinar to discuss the 2018 home health final rule and its impact on home health agencies. Stay tuned for details!