The proposed 2016 PPS rule for home health means Medicare will continue to overpay agencies, according to Aug. 18 comments by  the Medicare Payment Advisory Commission (MedPAC).
 
The comments echo MedPAC opinions of prior years that Medicare payments are excessive relative to actual patient care costs.
 
Under the proposed rule, rebasing would cut the 60-day episode rate by 2.73%, though based on the latest CMS figures the reduction needed to align payments with costs should be 5.02%, MedPAC contends. MedPAC further notes that after proposed wage index and case-mix adjustments projected to reduce the episode rate and the offsetting payment update increase, the per-episode reduction next year still only would be 0.78%.
 
MedPAC also endorses CMS plans to develop value-based purchasing for home health, saying this would eliminate use of therapy visits in determining episode payments – and eliminate manipulation of the therapy thresholds “for financial gain.”
 
However, CMS should consider consolidating or eliminating the 12 adverse event measures, 38 outcome measures and the 29 process measures it intends to use as quality measures. Some may be “redundant or unnecessary,” the commission says.