Comments for Proposed Rule. Some of the most important issues raised by the Proposed Rule aren't simply about what CMS is proposing. They're about the questions the home health industry should be asking CMS to answer. I recently submitted my comments to CMS regarding...
Outliers: A Benefit… But at What Cost? Looking Beyond the Payment to Better Understand the Medicare Home Health Outlier Provision The Outlier Provision was created as a financial safety net to help preserve access to care for Medicare beneficiaries whose care requires...
Why the Home Health Spending Adjustment May Not Reflect the Impact on Your Agency Each year, when CMS releases the Home Health PPS Proposed and Final Rules, one of the most widely discussed figures is the projected change in Home Health Spending (HHS). Industry...
Each year, when CMS releases the Home Health Prospective Payment System (PPS) Proposed and Final Rules, much of the industry's attention focuses on a single number: the projected change in Home Health Spending (HHS). While that figure may provide useful information...
and planning for the CY2027 HH PPS Proposed Rule Following are some updates, articles, and information applicable to Hospice (above), and Home Health (below), that all should be aware of, and preparing for where appropriate: Hospice Issues/Considerations: The 2027...
The Centers for Medicare & Medicaid Services has signaled that new program-integrity initiatives may be on the horizon… This initiative is aimed at improving fraud detection and preventing improper payments in Medicare, Medicaid, CHIP, and Marketplace programs.
2026 HH PPS FINAL Rule cover page A reprieve, but still a cut to home health spending! Overview of the Final Rule The Centers for Medicare and Medicaid Services (CMS) released the final rule for the Home Health Prospective Payment System (HH PPS) for 2026 later than...
The 2025 HH PPS FINAL Rule, published by CMS projects an increase of approx. $85 million, an increase of 0.5% in home health spending.
The use of financial fundamentals in home health will help leadership to better understand the agency and achieve greater profitability.
Case-Mix Weights are a numeric representation of a beneficiary’s acuity level, The greater the Case-Mix Weight, the greater the acuity. The Case-Mix Weight is used by CMS to help allocate resources ($) for the care of any given beneficiary.