2012 payment changes are finalized

The down and dirty: Payments to home health agencies (HHAs) are estimated to decrease by approximately 2.31 percent or $430 million in CY 2012, the net effect of a 1.4 percent payment update, the wage index update, and the case-mix coding adjustment. 

Hypertension has officially been removed from the case-mix list, payments have dropped for high-therapy episodes, and case-mix weights have been recalibrated.

The Affordable Care Act applies a 1 percentage point reduction to the 2012 home health market basket amount.  As the 2012 market basket is equal to 2.4 percent, the payment update for HHAs in 2012 will be 1.4 percent, according to the Center for Medicare and Medicaid Services. 

CMS also reduced HH PPS rates in 2012 to account for additional growth in aggregate case-mix that is unrelated to changes in patients’ health status.  CMS has finalized a 3.79 percent reduction to the home health PPS rates for 2012 and an additional 1.32 percent reduction for 2013.

The final rule is in the Federal Register. .   

CMS’s main HH PPS page is here.

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