In certain circumstances, for some patients, CMS might grant ACOs a waiver that would allow home health agencies to provide care to patients who aren’t homebound.
 
This suggestion was part of a proposed rule addressing changes to the Medicare Shared Savings Program, including provisions relating to the payment of ACOs. The proposal was posted Dec. 1 on the Federal Register.
 
Allowing for the care of patients who aren’t homebound “could be beneficial to the industry, to the extent providers are in ACOs,” says attorney Robert Markette of Hall, Render, Killian, Heath & Lyman, in Indianapolis. The concept, he argues, makes sense because home health services could help reduce costs for ACOs. Providing care to patients beyond those who meet the traditional eligibility requirements has always been an issue in discussion for ACOs because of the question as to how they would afford to provide a service that would not be reimbursed by Medicare.
 
A home health agency might be able to provide care a lower cost than the hospitals or physicians, and the agency’s care would lead to a reduction in readmissions, he adds.
 
See an upcoming issue of HHL to learn more about the proposed rule.
 
Related link: View the proposed rule at: http://1.usa.gov/1yCK07K.