Posted Monday, June 27, 2022
As providers prepared for the release of the proposed payment rule, many knew that CMS’ analysis of whether the Patient-Driven Groupings Model (PDGM) led to higher, lower or equal spending compared to the old payment model would be a major factor, according to William A. Dombi, the president of the National Association for Home Care & Hospice (NAHC).
“Many are pushing back against CMS’ methodology for assessing budget neutrality, with organizations such as NAHC expressing their concerns even prior to the release of the proposed rule.”
“When we found out on Friday that CMS chose to use the same methodology which had been roundly condemned by anybody who had evaluated it, we had to conclude the CMS had effectively declared war against home health,” Dombi said. “I don’t mean that in an emotional sense, but in a practical sense, where the outcome of this proposal could be extraordinarily — not just disruptive — but devastating to the home health care community.”
“CMS only gets to that [$810 million] by adding in the inflation update, so the inflation update for 2023 is a meager 2.9%. The proposed rule also includes a 7.69% PDGM budget-neutrality adjustment. “It’s startling to see in this period of high inflation, this tremendous change in the level of the base payment rates,” Dombi said.”
“This is not a proposal that we can just feel comfortable and relaxed with to move forward with,” Dombi said. “This is a rule which is going to require a significant amount of advocacy efforts from all of us, in order to end up with an alternative outcome than what we see proposed here by CMS.”
Click here to read the full article from HHCN.
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