Medicare officials announced Aug. 22 a decrease in Medicare payments for home care services for 2008, drawing sharp criticism from home care lobbyists.
The Centers for Medicare & Medicaid Services' final rule to refine and update the Home Health Prospective Payment System (HH PPS) for 2008 will channel an estimated additional $20 million in payments to home health agencies, CMS said.
But the rule also reduces the national standardized 60-day episode payment by 2.75 percent per year for three years and 2.71 percent in the fourth year. The reductions account for case-mix changes that are not related to home health patients' actual clinical conditions, CMS said.
The home health market basket increase for 2008, which is based on inflation in prices and services and the submission of quality data, has been set to 3.0 percent, resulting in $430 million in payments. The market basket increase in 2007 was 3.3 percent.
Home health agencies that do not submit quality data will only receive a 1.0 percent market basket update, CMS added.
The National Association for Home Care & Hospice derided CMS' rule as "undermining access to care in patients' homes and diminishing the importance and value of planned reforms to the Medicare home health services payment methodology."
NAHC said the rule reduces overall pay rates by 12 percent over four years and therefore cuts payments to home care by nearly $7 billion.
"If Congress allows Medicare to put these cuts in place, over 50 percent of all home health agencies will be paid less than it costs to deliver care," said Val J. Halamandaris, president of NAHC. "The predictable result will be that our healthcare spending will increase exponentially as patients who lose access to home care seek out healthcare services in much more expensive institutional settings," Halamandaris said. "It makes no sense."
According to Herb Kuhn, acting deputy administrator of CMS, "This rule continues the agency's effort to improve the efficiency and quality of care for Medicare beneficiaries."
CMS' final rule also adds to the HH PPS two new quality measures regarding wound treatment, bringing the total number of quality measures in the pay system to 12.