tci Medicare Compliance & Reimbursement - 2004 Issue 37
Home Health: MedPAC Wants HHA Payments Tied To Quality
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Article Overview
This article covers Medicare policy discussions about whether home health agency reimbursement should be tied to quality performance. It explains the quality measurement approaches MedPAC is considering, the concerns raised by industry and commissioners about measurement validity and patient mix, and the possible role of CMS and Quality Improvement Organizations if a payment-quality link moves forward. The piece is relevant to home health billing and compliance professionals, agency administrators, and anyone tracking Medicare payment policy.
Why This Topic Matters
It describes a potential shift in how home health agencies may be paid under Medicare and highlights the measurement systems and operational issues that could affect reimbursement, reporting, and quality improvement efforts.
Article Sections
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MedPAC’s quality-based payment discussion
Introduces the advisory commission’s consideration of linking home health payment to quality measurement and the policy context behind the discussion.
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Quality measures under review
Summarizes the broad categories of Medicare and other quality indicators being evaluated for possible use in payment policy.
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Concerns about measurement and patient mix
Covers concerns raised about data reliability, risk adjustment, patient characteristics, and factors outside agency control.
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Possible next steps for Medicare and providers
Describes the expected direction of MedPAC’s recommendation and the general support resources available to agencies if quality-linked payment is adopted.
What You Will Learn
- The policy issue MedPAC is weighing for home health payment
- The general categories of quality measures being considered
- The main types of implementation concerns discussed by stakeholders
- How Medicare and provider support structures may factor into future changes
Who Should Read This
- Home health agencies
- Medical coding and reimbursement professionals
- Healthcare compliance staff
- Medicare policy analysts
- Quality improvement teams
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