The 2023 AHCA/NCAL National Quality Award Program recipients have been announced and we are extremely pleased to congratulate the impressive 127 SHP clients who received the award this year.

The annual SHPBest™ award program was created to recognize home health and hospice providers that consistently provide outstanding performance in patient and caregiver satisfaction. SHP would like to congratulate the 2022 SHP Best-of-the-Best winners, who have been acknowledged for achieving the highest overall HHCAHPS patient satisfaction or CAHPS Hospice caregiver satisfaction scores of all eligible SHP clients during the 2022 calendar year.

CMS shared the details of the new Hospice Special Focus Program (SFP) in the CMS Home Health Prospective Payment System Proposed Rule posted in the Federal Register on July 10th. While expected, CMS often adds rule-making for non-home health services when either timing or urgency makes it necessary. Based on the scrutiny Hospice has been under from numerous OIG reports and the negative publicity from articles written by ProPublica and the New Yorker, Hospice has been in the crosshairs of increased oversight.

The proposed CMS Home Health Prospective Payment System Rate Update was released on Friday, June 30th in advance of the official posting to the Federal Register on July 10th. CMS is proposing an overall 2.2% rate cut that includes a market basket increase of 3.0% (less a productivity adjustment of .3%) along with a 5.65% cut due to permanent behavioral adjustments in switching from PPS to PDGM. Since the CY 2023 rulemaking reflected only half of the permanent behavioral cuts (using data from CY 2020 and CY 2021), CMS is proposing to implement the second half of the CY 2023 cut along with another 1.51% to account for behavioral changes recognized in CY 2022.

In the Medicare and Medicaid CY 2022 Home Health Prospective Payment System Rate Final Rule, CMS finalized the Home Health Value-Based Program (HHVBP) national expansion based on their original proposal. However, there is one exception - a one year delay in implementing the program. This is good news for providers in the 41 states which are currently not part of the CMMI HHVBP demonstration, but agencies are still expected to use this time to prepare.

In the Medicare and Medicaid CY 2023 Home Health Prospective Payment System Rate Final Rule, CMS finalized the PDGM permanent behavioral adjustment of 7.85% to be phased in with only half of the rate being adjusted in CY 23. Including the higher revised market basket adjustment of 4.1%, reduced by the productivity adjustment of .1%, CMS is predicting HHAs revenues to increase by 0.7% or $125 million in CY 2023 compared to CY 2022. This compares to the proposed rule where payment rates would decrease by 4.2% or $810 million.

The 2022 AHCA/NCAL National Quality Award Program recipients have been announced and we are extremely pleased to congratulate the 64 SHP clients who received the award this year.

The proposed CMS Home Health Prospective Payment System Rate Update was posted to the Federal Register on June 23rd, a bit earlier in the annual rule-making cycle than the past several years. As part of the overall reimbursement cuts, CMS is proposing a 7.69% rate cut to reflect their calculations on behavioral adjustments. These adjustments are intended to account for the actual vs assumed behavior changes on aggregate expenditures due to the switch from HH PPS to PDGM. Keep in mind this is a prospective rate cut starting in CY 2023, and does not address the overpayments from CY 2020 and CY 2021. CMS has requested comments on how to recoup these overpayments.

The new PDPM Impact Report is here. The latest IntelliLogix™ update is designed to allow skilled nursing facilities to see the financial impact realized from MDS Scrubber utilization for PPS assessments. It also allows the user to drill down into specific facilities and resident detail highlighting resident characteristics and alert changes.

The annual SHPBest™ award program was created to recognize home health and hospice providers that consistently provide outstanding performance in patient and caregiver satisfaction. SHP would like to congratulate the 2021 SHP Best-of-the-Best winners, who have been acknowledged for achieving the highest overall HHCAHPS patient satisfaction or CAHPS Hospice caregiver satisfaction scores of all eligible SHP clients during the 2021 calendar year.