Home Health & Hospice Week

Are you ready to share a payment system with other post-acute providers?

Would a prospective payment system that spans post-acute provider types be a boon or a bust for home care providers? You may find out sooner than you think.

The Medicare Payment Advisory Commission is laying the groundwork to recommend a methodology for a PPS that would cover home health agencies, skilled nursing facilities, inpatient rehab facilities and long-term care hospitals, according to a presentation from its meeting last month.

Two models MedPAC has developed are “accurate and could be used to establish payments,” MedPAC staff said.

MedPAC would urge a system that “would hold PAC providers accountable for resource use during the episode of care.” The Commission may recommend an episode that includes the first PAC stay and 30 days after discharge, the presentation indicates.

Boon: Home care is the most cost effective of the PAC settings listed, so it could be an attractive option for referrals under the system, potentially boosting census.

Bust: Partners could try to limit home care use as an unnecessary cost after discharge from acute or other PAC settings. And control of agencies’ reimbursement may be put in another organization’s hands — perhaps a third party, MedPAC suggests in the presentation.

Stay tuned for MedPAC’s March report to Congress to see the final PAC PPS recommendation.