Reinventing Home Health

Accountable care is finally coming to home health.
The Centers for Medicare and Medicaid Services (CMS) is launching a value-based reimbursement (VBR) pilot program for Medicare home health care agencies. The model is part of the 2016 Home Health Prospective Payment System proposed rule, which was published in the Federal Register on July 10.
In the current reality of home health care, if you are a home health provider and not part of a hospital or health system, your world looks something like this:

A hospital discharge planner (your customer) chooses which agency will care for the homebound patient (also your customer).
CMS (another customer) dictates how much you get paid and has recently decided to pay you less every year.
You itemize every last thing you do and spend hours learning coding techniques to maximize how much you get reimbursed.
And by the way, you have a hard time finding people to work for you at a wage where you can be profitable.

Home health care sounds like a miserable business to be in. And if there ever was a golden age for home care, it certainly became a more challenging endeavor after CMS set its sights on value-based payments. Everything about the home health business is fee-for-service, which is bad news if CMS is writing the checks.
Through accountable care organizations (ACOs) and other Innovation Center initiatives, CMS’s goal is to transition from fee-for-service to performance-based compensation, and eventually, to full capitation like Med...

Source: Health Affairs Blog - August 11, 2015 Category: Health Management Authors: John Marchica Tags: Costs and Spending Health Professionals Long-term Services and Supports Medicare Payment Policy Population Health ACOs BAYADA CMS home healthcare triple aim value-based reimbursement Source Type: blogs