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Home Health & Hospice Week

Prospective Payment System:

2.3% Pay Cut Hits Freestanding For-Profits Hardest In 2012

Published on Mon Oct 04, 2010

Case mix changes reduce reimbursement rates for high-therapy episodes. The home care industry's call to halt cuts for so-called case mix creep fell on deaf ears at CMS. Medicare payment rates for home health agencies will fall 2.3 percent starting Jan. 1, the Centers for Medicare & Medicaid Services says in a 236-page final rule posted to the Federal Register website Oct. 31. The new base per episode rate will be $2,138.62 in non-rural areas and $2,202.68 in rural areas (see charts, p. 307, for NRS and per visit LUPA rates.) That's down from $2,192.07 and $2,257.83, respectively. CMS calculated the cut by reducing the 2.4 percent inflation update by 1 percent as required by law, then adding on a 3.79 percent cut for case mix creep -- an increase in case mix that CMS says isn't due to actual changes in patient acuity. The cut will strip $430 million from [...]
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