The Centers for Medicare & Medicaid Services is recommending an estimated 1.7% increase to home health agencies in calendar year (CY) 2022, the agency disclosed late Monday in its voluminous 387-page proposed rule. It also disclosed it would expand the Home Health Value-Based Purchasing (HHVBP) Model to all 50 states, recalibrate Payment-Driven Groupings Model (PDGM) case-mix indexes and make permanent public health emergency (PHE) provisions.
The home care community said that rule reflects a measured approach during a time of upheaval.
“All told, the proposed rule is complex, ambitious and cautious at a time when the public health emergency continues,” Bill Dombi, president of the National Association for Home Care & Hospice, said in written comments following release of the rule. “NAHC agrees that CMS should be cautious at this unsettled time and we recommend CMS avoid taking premature steps that could disrupt a fragile healthcare system based on a myriad of assumptions and limited data from a chaotic period. In that respect, NAHC appreciates that CMS is avoiding taking potential actions without reliance on comprehensive data. NAHC looks forward to providing detailed formal comments to CMS during the rulemaking period with reasoned recommendations that control for service delivery risks.”
CMS said the overall economic impact of the payment rate update is an estimated 1.7%, or $310 million, the agency said Monday. In CY 2021, CMS provided a 2% home health payment update percentage, or a $410 million increase.
The agency provided other key recommendations in its report issued Monday. Among them: It recommends expanding the HHVBP Model to all 50 states. It also said it proposed ending the original HHVBP Model one year early for the home health agencies in the nine original model states.
PDGM also was the subject of the proposed rule. CMS disclosed it is proposing to recalibrate the PDGM case-mix weights, functional levels and comorbidity adjustment subgroups while maintaining the low utilization payment adjustment (LUPA) thresholds for CY 2022.
Also, as part of the rule it recommends making permanent selected regulatory blanket waivers related to home health aide supervision that were issued to Medicare participating home health agencies during the PHE. It proposes allowing occupational therapists to conduct home health initial assessment visits and complete comprehensive assessments for patients.