Medicare Compliance & Reimbursement

The program is voluntary -- for now. CMS has unveiled a payment methodology home care organizations have been fearing, but it could have some upsides. As part of the Affordable Care Act, the Centers for Medicare & Medicaid Services is required to test payment bundling models. Home health agencies have worried that bundling would put hospitals in control of their Medicare payments, leaving agencies at their mercy for both referrals and payment rates. However: In its new Bundled Payments for Care Improvement initiative, CMS notes that the project will provide "traditional fee-for-service payment to all providers and suppliers." The catch: Later, those payments will be "reconciled" according to a discounted target price that the providers involved in bundling agree upon. However, if Medicare spending for a patient is actually below the target price, CMS will pay that reduction amount "to the participants to share among the participating providers," CMS notes in [...]