MedPAC Releases Recommendation on New PPS for Home Health by 2021

Posted on Monday, April 17, 2017 11:44 AM

The Medical Payment Advisory Commission (MedPAC) decided to implement a new prospective payment system (PPS) for home health that could come as soon as 2021. MedPAC unanimously voted to start the PPS sooner than originally planned and presented the date to Congress in its April meeting. The original date was scheduled for implementation in 2023 or 2024.

MedPAC members voted 15-0 for approval on its recommendation to Congress.

The main objective for the new PPS is to combat payment issues embedded in the current system, along with incentives to provide types of care for certain patients.

“By rebalancing the financial incentives, the PAC PPS will correct the current inequities in the SNF and home health PPS that favor some types of patients and providers over others,” Carol Carter, Ph.D, Principal Analyst at MedPAC, said during the meeting.

Over five years, spending is expected to be lowered by between $5 billion and $10 billion, according to MedPAC.

“For beneficiaries, providers will be more willing to treat all types of patients, and therefore, there should be less selection among different types of patients,” Carter said.

“For providers, the [post-acute care] PAC PPS will redistribute payments across providers,” Carter said. “The impacts will depend on provider responses and will vary wildly depending on each provider’s cost, their mix of patients and their current treatment practices.”

Throughout the year, MedPAC will turn its attention to regulatory alignments across PAC settings, according to Carter.

Congress doesn’t have to implement the plans as MedPAC recommendations aren’t always followed.

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