The proposed rule for 2015 brings another decrease to home health reimbursements, in large part due to the rebasing adjustments required by PPACA. The effects of the rules proposals may be more significant to your agency than appears on the surface with the overall cuts estimated at 0.3%. For example, CMS outlines in the proposal to cull about 200 diagnosis codes from the case mix system and remove two OASIS items. The proposed changes to the case mix system, for example would remove diabetes as a primary diagnosis and would no longer result in points in an early or late episode with low therapy. In fact, the greatest losses in case mix points are in the non-therapy or low therapy equations where reimbursements where already lower.
We encourage you to review all of the new case mix weights to determine the impact on your home health agency. If your home health agency does not have a good percentage of therapy patients, next year’s reimbursements may be devastating.