McB Insights: The Buzz Around the CMS Proposed Prospective Payment System Updates
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4 August 2017 - 14:53, by , in News, Comments off
Contributors: Mike Dordick, Executive Vice President, and Keith Boroch, Assistant Vice President – Post Acute

Early last week, CMS unveiled its new prospective payment system (PPS), which means that cuts to Medicare home health reimbursements for 2018 and a major overhaul of how home health care agencies could be paid in 2019 is underway.

This proposed change has a significant impact on the post acute industry.  These changes impact all provider across the continuum of care. No matter if the provider is a health care system, hospital, home health, home care, hospice, skilled nursing home, sub-acute facility, or long-term care; each is faced with changing regulations, increased scrutiny, quality demands, decreased operating costs, and workforce challenges—likely resulting in declining revenue.

It is the most sweeping change since the PPS structure was implemented in August of 2000.

With the CMS focused on bundled payments and value-based purchasing, the current environment has caused non-health system or hospital-affiliated home health agencies to question their long-term relevance and value proposition. These providers are finding with the continual development of “preferred provider networks” issued by health systems that they are losing access to traditional referral sources.

There is a risk that agencies will be significantly harmed through this proposed rule with the greatest impacts being seen in rural areas where patients may not have access to other care.  McBee is positioned very well to help our clients navigate this time of transformation and will be working closely with NAHC and the Partnership for Quality Home Healthcare to challenge the proposed change.

Learn more about the CMS Proposed Payment Changes for Medicare Home Health Agencies.


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