Home Health Payment Rule 2023 - Home Health Care

Home Health Payment Rule 2023


Hello everyone and Welcome to our Sunday minute. Today we're going to discuss the 2023 Home Health Repose rule. This rule has been very unsettling to many. It includes a 2.9 percent increase in the base rates based on inflation in the Market Basket, which is in my opinion a joke. We all know that given the current situation with inflation in the Market Basket that, 2.9 percent doesn't even begin to scratch the surface.
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Home Health Payment Rule 2023 - Home Health Care
Home Health Payment Rule 2023 - Home Health Care

Behavioral Adjustment 

To make things even worse or add salt to injury, they are now saying they're going to apply the adjustment, behavioral adjustment, that they had originally proposed at the beginning of PGDM. They are now saying that that is over seven percent and that that seven percent behavioral adjustment combined with the 2.9 percent increase um and one other adjustment, we're basically looking at a 4.2 percent decrease in the overall rates for home health moving into 2023.

Crisis Situation

I don't have to tell you how upsetting it is that we are facing a decrease of 4.2 percent in our rates when we are currently dealing with the lack of staff, um the retention of staff, gas prices which uh directly impact Home Health Agencies um inflation, the cost of living, I I just can't contain how I feel about this. We are in a crisis situation where it is more important than it's ever been before that your comment um before this final rule is released, and that you make sure your voice is heard. Having just the state alliance and the National Association remark on this rule is not going to get it. We as individual entities in the home health industry are going to have to participate in advocacy surrounding this rule.

Baseline Year

In addition to the right uh situation, they are also proposing that the Baseline year, or the Value-Based Purchasing model, be implemented in 2023, be changed to 2022 instead of the originally finalized year 2019. They have in this role updated the definition of the model Baseline year and the agency Baseline year, the model Baseline year being the Baseline year that will be utilized for the benchmarks and achievement thresholds while the individual agency Improvement thresholds, would be based on the agency's Baseline year. If they do change the Baseline year to 2022, then everyone's model Baseline and individual agencies' Improvement Baseline years will both be 2022. That will, of course, be for any agency that was Medicare certified prior to January 1st to 2022. Anyone who becomes Medicare certified in 2022 would not participate in Volume-Based Purchasing until they have had one full calendar year of activity. If they have Medicare certification in 2022, they would have the full year of 2023, of operation, and they would begin to participate in value-based purchasing in 2024. 

There are multiple things included within this rule. We will be releasing a detailed blog over the next couple of weeks with some of the um more definitive information regarding this rule. For the cause of this Minute, I wanted to make sure you understood that there is a rate reduction being proposed for home health and that we as an industry have to speak up, and we are expecting that all agencies will. We will include um in this Minute, the link to the final rule itself, which also contains the link where you can actually comment online. 


We want to thank you all for participating today, and for continuing to care for patients in this extended Public Health Emergency. We appreciate the fact that you are still out there taking care of patients regardless of the situations um that we are now having to battle, now inclusive of a possible rate reduction. Please confirmed that you stay close to your state and the National home care and hospice alliance and take part in all of the education that they have available to you. Confirmed to pay attention to their approval that is continuing both at the State level and National level, but specifically, today as it pertains to this rule. Thank you again and if Home Health Care (HHC) can never assist please don't hesitate to let us know.

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