Home Health & Hospice Week

It’s not just your imagination — Medicare is out to cut therapy reimbursement with the Home Health Groupings Model.

“HHAs that provide a larger percentage of overall visits as therapy visits compared to skilled nursing visits may experience larger decreases in payments under the HHGM,” the Centers for Medicare & Medicaid Services says in the HH PPS rule proposing the payment reform model. “We do not believe it would be appropriate to offer regulatory relief, or otherwise mitigate the impact of the proposed HHGM, for HHAs that provide a preponderance of their visits as therapy visits compared to nursing visits. The HHGM would still provide adequate reimbursement for therapy services and was developed, in part, to eliminate the current therapy thresholds that encourage the provision of the most profitable number of therapy visits, even when patient need may not justify such services.”

“We anticipate that HHAs currently providing excess therapy visits solely to maximize reimbursement … will no longer do so under the HHGM,” CMS adds.