Home Health & Hospice Week

Revised case-mix groups could debut in 2008.

Your Medicare profit margins could drop under a home health payment system the feds have in the works.

That's the word from insiders about major revisions to Medicare's home health case-mix system.

The Centers for Medicare & Medicaid Services plans to issue a final rule regarding changes to Medicare's home health payment system next summer, a spokesperson from Abt Associates tells Eli. Abt Associates, a Medicare contractor and research firm based in Bethesda, MD, has contracted with CMS to revise the home health payment system.

Agencies should look for a proposed rule about four to five months before that, given that CMS will need to allow time for comments on the proposed changes.

Mark your calendar: That means you're likely to have a glimpse of payment changes by March 2007. The new system could be implemented as soon as 2008.

Hidden drawback: Though CMS hasn't formally revealed information about how the revisions would affect home health payment, an article in the publication Inside CMS earlier this year suggested that the system could cut profit margins for some home health agencies, especially for large players (See Eli's HCW, Vol. XV, No. 27).

Proposed changes relate to home health case-mix adjustments, therapy visit thresholds and reimbursement for medical supplies, according to the publication.

Medicare's home health payment system hasn't been updated since its inception in 2000.

Abt researchers report a number of areas where the case mix system could be refined, including home IV, parenteral and enteral therapy, pressure and stasis ulcers, multiple sclerosis, and type I and type II diabetes with injectable drugs, according to Inside CMS.