tci Medicare Compliance & Reimbursement - 2015 Issue 14

Home Health Reimbursement: Value-Based Purchasing Steals The Show

Expect payment to take a hit. Home health agencies’ worst nightmares seem to be coming true. Pay for performance in the guise of a value-based program could hit come January, and outcomes will dictate future reimbursement.  Under the Centers for Medicare & Medicaid Services’ (CMS’) proposed VBP program (formerly known as pay for performance [P4P]), all home health agencies in nine pilot states will be subject to the program starting Jan. 1 (see box, p. 110, for states). CMS will “adjust” up to 5 percent of those agencies’ Medicare reimbursement for 2016 and 2017 outcomes; up...

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