Tuesday, July 2, 2013

Home Health Rates 2014

On Friday we published an Email Blast about the Proposed Home Health PPS Rates for 2014.  This is the second article about the Proposed PPS Rates.  Today we will list the actual episode payment rates, LUPA payment rates and Non Routine Medical Supply Rates.  Look for more Email Blast this week about the Proposed Home Health PPS Rules and Rates for 2014.

Base Urban Episode Rates Before Case Mix and Wage Index Adjustments
Description
2014
2013
Variance (*)
% Variance
Standard Episode Payment Rate
$2,860.20
$2,137.73
$722.47
33.80%
(*) CMS increased the base rate by 35.17% as part of standardizing the case mix rate.  The 33.80% increase is really a decrease because of the artificial increase of 35.17% in the base rate to account for the 35.17% decrease in case mix rate.  Remember your episode case mix rates will be decreased by 35.17% so for example C1F1 with 0 to 5 therapy visits will go from 0.8186 case mix rate in 2013 to 0.6056 in 2014.

LUPA Rates Urban Agencies Before Wage Index Adjustments
Description
2014
2013
Variance
% Variance
Skilled Nursing
$121.23
$114.35
$6.88
6.02%
Physical Therapy
$132.56
$125.03
$7.53
6.02%
Occupational Therapy
$133.46
$125.88
$7.58
6.02%
Speech Pathology
$144.03
$135.86
$8.17
6.02%
Medical Social Work
$194.34
$183.31
$11.03
6.02%
Home Health Aide
$54.91
$51.79
$3.12
6.02%

Medicare has proposed a change to the LUPA Add-On payments instead of a flat LUPA Add-On payment Medicare will base the LUPA-Add On payment based on which discipline makes the initial visit. 
LUPA Add-On Payment Amounts Before Wage Index Adjustments
Description
Base
2014
Rate

Add-On
Factor
Revised
Rate
1st Visit
Skilled Nurse makes initial visit
$121.23
1.8714
$226.87
Physical Therapist makes initial visit
$132.56
1.6841
$223.24
Speech Pathologist makes initial visit
$144.03
1.6293
$234.67

Medicare has proposed a cut of 2.4% for Non-Routine Medical Supplies 2014, 2015, 2016, and 2017.
Non-Routine Medical Supply Base Rate
Description
2013
Factor
2013 Rate
$53.97
2014 Rebasing adjustment (x 0.9742)
$52.58
2014 HH Market Basket (x 1.024)
$53.84


Proposed 2014 Non-Routine Medical Supply
Severity
Points
Relative Weight
Proposed NRS Payment Amount
1
0
0.2698
$14.53
2
1 to 14
0.9742
$52.45
3
15 to 27
2.6712
$143.82
4
28 to 48
3.9686
$213.67
5
49 to 98
6.1198
$329.49
6
99+
10.5254
$566.69

Remember that all rates must be adjusted for urban and rural home health agencies.  LUPA Rates and Episodes Rates must be adjusted by wage index.   Episode rates must be adjusted by wage index and case mix.  Home health agencies that do not submit quality data will receive an additional 2 percent cut in payments. 


We sent a note out to home health agencies last week titled “It is Time to Step Up or Fall Behind”.  We stated that your home health agency is currently going up the down escalator.  The current momentum of the health care industry is constantly pushing your company down, just like a down escalator is constantly moving down.  To step up to the next star, you adapt and embrace the changes or place your head in the sand and move further down the escalator. 

If you would like to step up instead of falling behind attend our Home Health Leadership Conference on September 23rd to September 25th at the Hilton Waikoloa Village on the “Big Island” in Hawaii. We will cover the home health proposed PPS Rule and methods to successfully adapt the changes.

For more information use the temporary link below (The final link will be available on July 3rd when proposed rule is published in the Federal Register):


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