'A Declaration of War': Inside the 2023 Home Health Proposed Payment Rule – Home Health Care News


stevepb/Pixabay | CC0
stevepb/Pixabay | CC0

The U.S. Centers for Medicare & Medicaid Services (CMS) effectively went to war with home health providers when the agency unveiled its 2023 proposed payment rule on June 17. At the heart of the conflict is differing views on how the Patient-Driven Groupings Model (PDGM) has impacted the industry.

Ultimately, CMS estimates that its proposal would slash aggregate home health payments by 4.2%, or $810 million, next year. The figure takes into account a 2.9% Medicare payment increase, plus a 6.9% cut aimed at balancing out PDGM and another 0.2% cut related to outlier payments.

If the agency moves forward with its plan, the ramifications on the home health market could be profound.

In particular, I see two clear consequences: a downturn in transaction activity and decreased investment in care innovation. The proposal itself may even be unfavorable enough where providers and investors already shift to more bearish mindsets in these areas, regardless of what happens with the final rule released in fall.


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When Robert’s not covering the latest in home health care news, you can likely find him rooting for the White Sox or roaming his neighborhood streets playing Pokemon Go. Before joining HHCN, Robert covered everything from big agribusiness to the hottest tech startups. 

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