The HHL team has compiled this quick-reference tool to help you evaluate the major provisions of CMS’ proposed rule. The following changes would take effect in 2016 if the rule is finalized as proposed. 
 
Provision
Content
Section
Payment
update
CMS estimates to a $350 million payment decrease in estimated Medicare payments in 2016. That decrease reflects a 2.3% increase in payments offset by a proposed reduction to the national, standardized 60-day episode payment rate in 2016 — “to account for nominal case-mix growth” — and the third year of the four-year phase-in of the rebasing adjustments as required by the Affordable Care Act.
   III. C. 1.
Home health value-based purchasing model
CMS plans to create a value-based purchasing model to be tested in nine states. Agencies that meet or exceed performance standards would be eligible for bonuses.
   IV.
Rate-setting changes
Core Based Statistical Area (CBSA) changes affect the home health wage index. In the 2015 PPS rule, a blended wage index was calculated as 50% of the CY 2015 wage index using current Office of Management and Budget (OMB) delineations and 50% of the CY 2015 wage index using revised OMB delineations. The proposed 2016 PPS rule CMS seeks to fully transition to the new CBSA designations.
   III. C. 2.
OASIS update
CMS proposes establishing a minimum threshold for submission of OASIS assessments for purposes of quality reporting compliance.
   III. V.
Case-mix weights
CMS is recalibrating the home health PPS case-mix weights, using the most current cost and utilization data available, in a budget-neutral manner.
   III.B.1
Skin integrity quality measure
CMS proposes a new quality measure that addresses the domain of skin integrity and changes in skin integrity. The IMPACT Act requires the specification of such a quality measure by Jan. 1, 2017.
   V. C.
Source: Proposed 2016 PPS rule