This summer, CMS unveiled an overhaul to the home health Medicare payment system. The proposed home health groupings model (HHGM) was created to replace the current 17-year-old Home Health Prospective Payment System (HH PPS). No doubt, the proposed HHGM rule is now the most significant transformation looming over the industry since 2000. For instance, not only does it substantially change episode timing, but also adds six new clinical groups to categorize patients primary reason for home health care. Additionally, the proposed rule redefines the low utilization payment adjustment (LUPA) threshold for home health agencies (HHAs) and requires HHAs to know where patients were 14 days prior to the episode.
“HHGM was meant to advocate budget neutrality… but it has not– it has created a major cut to the industry…leading to a major challenge for [home health agencies],” says Mike Dordick, McBee’s Executive Vice President, Principal.
Accordingly, Dordick evaluates the key areas of impact and the challenges HHAs may face with the new model as it’s proposed today in the video below.
McBee continues to advocate for fair home health industry regulations. Additionally, our leadership ensures that HHAs have the insights needed to understand the proposed HHGM. We will provide more insights as updates to the HHGM rule are made. Let us know of any questions or concerns you have regarding HHGM and we will be happy to help.
Mike Dordick, Executive Vice President, Principal–McBee
Mike has more than 20 years experience in health care financial and management consulting. He leads McBee’s Post Acute Division and works with home health and hospice providers to improve clinical outcomes, increase cash flow, and develop best practices in operations.