Home Health Reimbursement: Your Reimbursement Could Hinge on Outcomes Come 2016

Why This Topic Matters

The piece highlights a significant potential shift in home health payment policy, including reimbursement at risk tied to outcomes and quality performance. It matters because agencies may need to prepare operationally and strategically for a model that could affect Medicare payments in selected states.

Article Sections

1. CMS proposal for home health value-based purchasing

   Introduces the planned home health value-based purchasing concept and places it in the context of CMS’s payment rulemaking. It outlines the broad purpose and timing of the proposed model.

2. How the model would work

   Summarizes the general framework CMS describes for the demonstration-style model, including its relationship to quality performance and its proposed state-based rollout. It also discusses the scale and structure of payment adjustments at a high level.

3. Reimbursement at risk and provider concerns

   Explains why providers are watching the proposed model closely and why the potential payment impact is significant. It presents commentary from industry experts on the financial exposure and implementation challenges.

4. Preparing outcomes data and submitting comments

   Focuses on the need for agencies to review outcomes data and identify improvement opportunities before implementation. It also notes the opportunity to provide feedback during the comment period.