Payments to home health agencies are estimated to be virtually unchanged next year, decreasing by approximately $10 million in CY 2013 (about 0.01%). This reflects the net effect of a 1.3 percent home health payment update, an updated wage index, an update to the fixed-dollar loss (FDL) ratio, and a case-mix coding adjustment intended to offset coding changes unrelated to changes in patient health needs.
This final rule reflects CMS's ongoing efforts to support Medicare beneficiary access to home health services while fostering greater efficiency, flexibility, payment accuracy and improved quality.
Medicare law applies a 1 percent reduction to the CY 2013 home health market basket update of 2.3 percent, resulting in a 1.3 percent home health payment update for home health agencies next year. As part of the 2012 HH PPS final rule, CMS finalized a reduction in rates of 1.32 percent in CY 2013 to account for growth in aggregate case-mix that is unrelated to changes in patients' health status. This is unchanged in this final rule. CMS will continue to monitor any future changes in case-mix and make updates as appropriate.
In acute or post-acute care settings, this final rule provides additional flexibility in certifying patients as eligible for the home health benefit. The HH PPS final rule makes changes that help ensure patients maintain access to therapy services, while reducing burden on home health agencies.
To view the final CY 2013 payment rule for Home Health, please visit the Office of the Federal Register website.