CMS plans to expand the pilot based on the value of home health across the country


CMS on Monday proposal expansion of its purchasing program based on the health value of the home across the country.

The CMS Innovation Center first tested the model in January 2016. The program changes payment for Medicare home health services based on volume to a system that pays for value and quality. Currently, all Medicare-certified health agencies in Arizona, Florida, Iowa, Maryland, Massachusetts, Nebraska, North Carolina, Tennessee and Washington participate in the program.

In the third evaluation report on the program, participants showed an average of 4.6% improvement in quality scores and an average annual savings of $ 141 million to Medicare from 2016-2018, CMS said. The January agency said it had planned to expand the model to no later than January 1, 2022.

Medicare patients at home face a unique set of challenges and the obstacles to getting the assistance they need, “CMS administrator Chiquita Brooks-LaSure said in a statement.” Today’s announcement is a reaffirmation of our commitment to these older adults and people with disabilities who are taking Medicare for the health care they need. This proposed rule would simplify service delivery and value quality over quantity – at a time when Americans need it most. ”

CMS has also proposed to make permanent some home health changes implemented during the COVID-19 pandemic.


The proposed rule would allow assistants to conduct 14-day supervisory visits for patients receiving qualified services via telecare. CMS always recommends that most visits be made during an on-site, in-person visit, and that the home health agency assistant use only telecommunications if something unexpected interrupts planned in-person visits.

“We believe that the current need for 14-day on-site supervision visits when a patient receives qualified services is an important component in assessing the quality of care and services provided by the caregiver (home health), and to ensure that support services meet the needs of the patient, ”CMS wrote.

CMS has continuously proposed that they allow occupational therapists to make initial assessment visits when occupational therapy is part of the home health care plan with either physiotherapy or speech therapy, and qualified nursing services are not initially part of the plan. of care, CMS said.

In addition, the rule calls for feedback on how to achieve health equity monitoring for all patients through policy solutions, CMS said.

Under the rule, CMS would also assess a two-percentage point reduction in the annual update of any home health agency that does not meet home health quality reporting requirements.

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