CMS releases CY 2024 home health PPS final rule; partially delays behavioral adjustments

The Centers for Medicare & Medicaid Services Nov. 1 issued its calendar year 2024 final rule for the home health prospective payment system, which will increase home health payments by a net $140 million, or 0.8%, in calendar year 2024, relative to the year prior. This update is the result of a 3.3% market basket update, reduced by a 0.3% productivity adjustment. In addition, the agency finalized only half of the behavioral adjustment that it had proposed, which was designed to achieve budget-neutral implementation of the Patient-driven Groupings Model. Specifically, CMS finalized a behavioral adjustment that will cut payments by a net 2.6%; the agency said that it had concerns about implementing the full adjustment given the impact such a large decrease would have on providers and so it will instead apply the remaining adjustment in future years. Finally, CMS also adjusted the fixed-dollar loss ratio for outlier payments, which will increase payments by a net 0.4%.

In addition, CMS finalized all proposals related to the HH Quality Reporting Program. This includes the adoption of two new quality measures, one of which would calculate the percentage of HH patients who are up-to-date with their COVID-19 vaccinations, as well as the public reporting of four previously adopted measures. For the HH Value-based Purchasing program, CMS also finalized all of its proposals without modification, including the replacement of five quality measures with three updated quality measures and updated weighting methodology to account for the alteration in the measure set.

The rule takes effect Jan. 1. AHA members will receive a Special Bulletin with additional details on the rule.