Expanding Value Based Purchasing In 2022: What Does Over $300 Million More Dollars To Our Industry Look Like?
September 30, 2021
Background Of Home Health Value-Based Purchasing
What Does The 2022 Expansion Look Like For Providers:
- Modification of quality measures: The goal in this is to look at decreasing some of the burden put on providers in the Home Health Quality Reporting Program and focus more on patient outcomes. It does include 2 additional quality measures that deal with promotion of care coordination. Under Executive Order 13985 given on 1/20/2021, the outcome is to better monitor patient outcomes in diverse populations. CMS is looking to focus on health equity in these diverse populations. CMS wants feedback on how to accomplish this through policy changes/ solutions. It is looking at better reporting on dual eligible beneficiaries, disability status, the LGBTQ+ community, religious minorities, and those dealing with ongoing poverty or inequality.
- Routine updates on home health and home infusion payment rates: CMS looks to adjust PDGM case mix, co-morbidities and functional levels. The one items that looks to remain the same are the LUPA thresholds. There does not appear to be an adjustment from 2021 to 2022 in this category.
- Updates to the Medicare Conditions of Participation: During the COVID-19 pandemic, CMS issued certain waivers that it is looking to make permanent. The first is the home health aide supervision waiver and the second is the ability for the occupational therapist to continue to complete the initial and comprehensive assessments for patients.
The ultimate outcome if enacted is an additional $310 million dollars in reimbursement to home health agencies in calendar year 2022. This is the continued shift in healthcare dollars being moved from inpatient care to home and community based services. Should you need assistance in helping your agency become clinically efficient and outcome based while fiscally sound, please call Kenyon Homecare Consulting
at 206-721-5091. Whether you call directly or contact us online
, we will put you in touch with a senior associate to help you reach your clinical and financial goals.
Results Based Consulting
Did you find value in this blog post? Imagine what we can do for your home care or hospice agency. Fill out the form below to see how we're leading the industry with innovation, affordability, and experience.
Contact Us
For a Plan of Correction to be effective, it must address the "Who, What, Where, When, and How" of the correction. It is the formal response to regulatory error.
Preparing for a CMS survey in home health or hospice requires shifting from "crisis mode" to a culture of continuous compliance. Preparation prevents surprise!
CMS survey readiness is about compliance with the Conditions of Participation (CoPs). Surveyors evaluate care in home visits, record review, and staff interviews.
Home care agencies are finding it more difficult to secure and maintain licenses. Administrative backlogs to new federal mandates threaten viability to small providers.
The home health industry is highly regulated, competitive, and constantly evolving. A qualified consultant can save time, reduce mistakes, and accelerate success.
OASIS and ICD-10 coding influence decision-making, reimbursement, quality reporting, and agency performance. Ensuring accuracy is essential for every home health.
Chronic diseases account for the majority of healthcare utilization and spending with a disproportionate share of hospital admissions, ER visits & long term costs
An experienced interim manager can provide stability, expertise, and momentum- if the right individual is selected during your time of need and transition.
OASIS plays a critical role in care planning, quality, reimbursement, and regulatory compliance and is also key to success and integrity of Medicare Home Health.
Policies and procedures serve as the foundation for consistent, fair, and effective operations. Your manual should be a living breathing guide for your agency.