CMS is
completely changing the methodology it outlier payment policy. It is changing from a cost per visit approach
to a cost per unit approach. This means
that visits with more minutes will count more toward outliers than visits with
less time per visit. The unintended (or
intended) consequence of this approach is to dramatically decrease the outlier
payments of daily visit diabetic and BID diabetic patients who cannot
self-inject insulin. CMS has tried for
many years to reduce the cost of these patients.
We performed
a simple analysis of the impact on outlier payments for these patients and
found payments for daily diabetic patients decreased by 40% and the BID
diabetic patient’s payments decreased by 57%.
These are dramatic cuts for these patients and will force the home
health agencies that are already losing money on these patients to lose even
more.
We intend on
providing more information on this at our upcoming conference in January in Las
Vegas.
To view the rule
please go to:
https://www.gpo.gov/fdsys/pkg/FR-2016-11-03/pdf/2016-26290.pdf
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