In the Medicare and Medicaid CY 2023 Home Health Prospective Payment System Rate Final Rule, CMS finalized the PDGM permanent behavioral adjustment of 7.85% to be phased in with only half of the rate being adjusted in CY 23. Including the higher revised market basket adjustment of 4.1%, reduced by the productivity adjustment of .1%, CMS is predicting HHAs revenues to increase by 0.7% or $125 million in CY 2023 compared to CY 2022. This compares to the proposed rule where payment rates would decrease by 4.2% or $810 million.

The 2022 AHCA/NCAL National Quality Award Program recipients have been announced and we are extremely pleased to congratulate the 64 SHP clients who received the award this year.

The proposed CMS Home Health Prospective Payment System Rate Update was posted to the Federal Register on June 23rd, a bit earlier in the annual rule-making cycle than the past several years. As part of the overall reimbursement cuts, CMS is proposing a 7.69% rate cut to reflect their calculations on behavioral adjustments. These adjustments are intended to account for the actual vs assumed behavior changes on aggregate expenditures due to the switch from HH PPS to PDGM. Keep in mind this is a prospective rate cut starting in CY 2023, and does not address the overpayments from CY 2020 and CY 2021. CMS has requested comments on how to recoup these overpayments.

The new PDPM Impact Report is here. The latest IntelliLogix™ update is designed to allow skilled nursing facilities to see the financial impact realized from MDS Scrubber utilization for PPS assessments. It also allows the user to drill down into specific facilities and resident detail highlighting resident characteristics and alert changes.

The annual SHPBest™ award program was created to recognize home health and hospice providers that consistently provide outstanding performance in patient and caregiver satisfaction. SHP would like to congratulate the 2021 SHP Best-of-the-Best winners, who have been acknowledged for achieving the highest overall HHCAHPS patient satisfaction or CAHPS Hospice caregiver satisfaction scores of all eligible SHP clients during the 2021 calendar year.

Since 2016, we’ve been measuring client satisfaction using a Customer Thermometer, receiving over 20,000 survey ratings and nearly 5,000 comments in that timespan. Our goal is to maintain a Net Promoter Score (NPS, a measure of customer satisfaction) of 90 or more from our customers.

CMS has moved forward with getting final approvals in updating the Home Health OASIS assessment version from ‘D1’ to ‘E’ effective next January 1, 2023. CMS is required to get approval from the Office of Management and Budget (OMB) as part of the process. As part of their information packet, CMS provided an OASIS change table, a revised OASIS-E form and an itemized list of each data element, along with their assumptions of estimated costs to implement. The estimate for the time clinicians will need to complete the 143 net changed data elements (see chart) will cost $340.9M annually with another $23.4M in one-time trainings.

The Medicare PDGM Prospective Payment System for Home Health recognized its second birthday on January 1st of this year. With two years of real-time data, I was interested in comparing the PDGM components and other key indicators to see how the second year compared to the first using the SHP National Database and the CMS CY 2022 Final Rule datasets. CMS also updated the Case-Mix Weights (CMWs) for each of the 432 Home Health Resource Groups (HHRGs) based on their analysis of CY 2020 claims (run as of July 12th, 2021). They used a four-step regression model that applied CY 2019 costs per visit (minutes) and non-routine supplies from claims to determine average resource use and the corresponding CMWs.

CareStat, a software platform that connects post-acute providers with hospitals/ACO, has added reports and analytics to include data from Skilled Nursing Facilities (SNFs). The previous version of CareStat included data only from home health agency (HHA) partners. Now health systems can proactively manage both their SNF and HHA networks to facilitate more effective care planning, quality oversight, and total cost-of-care management.