The Obama administration’s budget proposal for 2014 includes a $100 copay for certain home health episodes and market basket reductions of 1.1 percentage points over several years.
 
The copay would be implemented starting in 2017 and would apply to episodes with five or more visits which aren’t preceded by a hospital or inpatient post-acute stay, according to HHS’ budget summary document. The copay proposal is identical to the one included in the fiscal 2013 budget. HHS estimates that the copay would save Medicare $730 million over 10 years.
 
The market basket reduction would begin in 2014 and continue each year through 2023. That would result in savings of $79 billion over 10 years when combined with similar reductions for inpatient rehab facilities, long-term care hospitals and skilled nursing facilities, HHS estimates.
 
Before any provisions of the proposal can be implemented, Congress would have to approve them.
 
Other key provisions of the proposed budget:
  • Implement bundled payments for post-acute providers starting in 2018. Payments would be bundled for “at least half of the total payments for post-acute care providers,” including home health agencies, long-term care hospitals, inpatient rehab facilities and skilled nursing facilities, HHS proposes. The federal agency projects $8.2 billion in savings over 10 years.
  • Strengthen the Independent Payment Advisory Board (IPAB). The board is authorized to recommend policies that would reduce Medicare spending growth if it exceeds a certain target. Under the budget proposal, the target rate for 2020 and after would be reduced, resulting in $4.1 billion in savings over 10 years, HHS estimates.
 
Look to the April 22 issue of Home Health Line for more in-depth coverage of the budget proposal.