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Home Health & Hospice Week

Prospective Payment System:

More Cuts For Case Mix Creep To Hit HHAs

Published on Tue Oct 13, 2009

Just how much the feds will dock you for perceived upcoding may depend on the health reform battle. You’ll be getting 2.75 percent less in Medicare reimbursement next year thanks to socalled case mix creep, and that cut may only get steeper in years to come. The Centers for Medicare & Medicaid Services set the home health agency episodic payment rate at $2,312.94 for 2010 in its prospective payment system rate update notice published in the Nov. 10 Federal Register (see Eli’s HCW, Vol. XVIII, No. 39, p. 298). That’s a net 1.75 percent increase over this year’s rate, because changes to outlier payments and an inflation increase offset the cut for case mix creep. CMS has made similar case mix creep cuts the last two years and already has set a 2.71 percent cut for 2011. But don’t count on the 2011 cut being the last one, or even staying [...]
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