Home Health Prospective Payment System Final Rule for CY 2024

AHA Regulatory Advisory
November 13, 2023

The Centers for Medicare & Medicaid Services (CMS) on Nov. 1 issued its calendar year (CY) 2024 final rule for the home health (HH) prospective payment system (PPS). New policies will generally be effective Jan. 1, 2024.

Key Highlights

The rule will:

  • • Increase HH payments by an estimated $140 million (0.8%) in CY 2024, relative to CY 2023, based upon: • a 3.3% market basket increase, reduced by a 0.3 percentage point productivity adjustment; • a 2.6 percentage point behavioral adjustment that CMS says is necessary to achieve budget neutrality under the Patient-driven Groupings Model (PDGM); and • an adjustment to the fixed-dollar loss ratio for outlier payments that will result in an estimated 0.4 percentage point increase in payments. • Rebase the HH market basket using updated claims and cost data. • Adopt two new measures to the Quality Reporting Program. • Replace five measures in the Value-based Purchasing program with three new measures and change the weights of the individual measures in scoring.

Regulatory Advisory Cover: CMS and ONC Propose Provider Disincentives for Health Care Information Blocking  .