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[Updated] CMS Finalizes 0.8% Home Health Payment Increase for 2024, Additional PDGM Cuts Home Health Care News | By Andrew Donlan The U.S. Centers for Medicare & Medicaid Services (CMS) released its CY 2024 home health final payment rule Wednesday. It comes with an estimated aggregate increase to 2024 home health payments of 0.8%, or $140 million, compared to 2023 aggregate payments. But that doesn’t tell the entire story, with sharp rate cuts also finalized. “The $140 million increase in estimated payments for CY 2024 reflects the effects of the CY 2024 home health payment update percentage of 3.0% ($525 million increase), an estimated 2.6% decrease that reflects the effects of the permanent behavioral assumption adjustment ($455 million) and an estimated 0.4% increase that reflects the effects of an updated FDL ($70 million increase),” the final rule reads. CMS is finalizing a permanent prospective adjustment of -2.890% to the CY 2024 home health payment rate, short of a -5.1% adjustment proposed in June. A -3.925% permanent rate adjustment was already implemented in 2023. The agency had proposed a 2.2% aggregate decrease in 2024 in June. The full fact sheet on the final rule can be viewed here. The Nuts and BoltsWhile a 0.8% increase in aggregate payments – compared to the 2.2% decrease proposed – is positive news in the near term, CMS is not backing off its desire for permanent, negative adjustments. The agency continues to maintain that it overpaid home health agencies during the first three years of the Patient-Driven Groupings Model (PDGM), too. The permanent prospective adjustment of -2.890%, while smaller than the 5.1% proposed, is something that providers and advocates hoped CMS would do away with completely. CMS is suggesting that home health agencies have been overpaid by about $3.5 billion from 2020-2022, which means clawbacks are still on the table. Specifically, CMS believes it overpaid by $873 million in 2020, $1.2 billion in 2021 and $1.4 billion in 2022. “A permanent prospective adjustment of -1.767% to the CY 2024 30-day payment rate (assuming the -7.85 percent adjustment was already taken) would be required to offset for such increases in estimated aggregate expenditures in future years,” CMS wrote in its rule. |
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