Saltmarsh Siren: Proposed 2025 Home Health Rules

7/30/2024 - By Kelly Smith, PhD, CPHQ, CLSSBB

The 2025 Proposed Rule for Home Health Agencies (HHAs) set forth by the Centers for Medicare & Medicaid Services (CMS) suggests significant changes for HHA providers. Specifically, those changes include:

A 2.5% net inflation rate update;
Recalibration of 432 case-mix weights and low utilization payment adjustment thresholds;
The addition of a reporting requirement related to health equity measures to better understand disparities and improve patient outcomes;
A behavioral health services adjustment to address changes in provider behavior that affect Medicare spending as part of CMS's ongoing effort to refine the Patient-Drive Groupings Model;
An extension of certain telehealth flexibilities that were initially implemented during the COVID-19 pandemic and would allow HHAs to offer remote services if/when they are clinically appropriate;
Changes to the Outcome and Assessment Information Set (OASIS) data collection requirements to reduce the administrative burden on HHAs;
New infection control and prevention requirements; and,
Updates to the Home Health Quality Reporting Program including removal and replacement of measures as set forth below:

Table of program removals and replacements.

These changes are part of CMS's broader efforts to enhance the quality of care provided by HHAs to promote health equity and ensure the financial sustainability of the Medicare program. Public comments on the proposed rule are being accepted through 08/26/2024. Click here to view the proposed rule and commentary option on the Federal Register's website.

If you have questions regarding the proposed changes, contact the Saltmarsh Healthcare Consulting team.

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About the Author | Kelly Smith, PhD, CPHQ, CLSSBB
Dr. Kelly Smith is a director in the Healthcare Consulting practice of Saltmarsh, Cleaveland & Gund. She has more than a decade of experience devoted to improving the quality of life and care for seniors and a strong background in quality framework implementation and process improvement. Dr. Smith supports provider efforts in the formation of integrated, system-based operations using data analytics to drive decision-making and seeks to transform the delivery of senior services through the design of customized process improvement initiatives, leadership development and dissemination of best practices.