Medicare Payment Policy

8-1
9–1
FIguRe
24
22
20
18
16
14
Medicare margin (in percent) FIGURE
12
10
2001
Source: Medicare cost reports.
2002
2003
Medicare margins....
Medicare margins of freestanding home health agencies since 2001
2004
2005
the new agencies since implementation of the PPS have and 2010 (Figure 9-1). The high overpayments have led
been for-profit providers.
the Commission to recommend that home health rates
Note: Note and Source are in InDesign.
be lowered to a level consistent with costs (Medicare
The Source: steep declines in services under the IPS do not appear
Payment Advisory Commission 2011). These high
to have adversely affected the quality of care beneficiaries
margins likely have encouraged the entry of new HHAs, as
received; one analysis found that patient satisfaction with
the total number of agencies participating in Medicare has
home health services was mostly unchanged in this period
increased by an average of about 532 agencies a year since
(McCall et al. 2003, McCall et al. 2004). An analysis
of the Balanced Notes Budget about Act this of 1997 graph:
2002 (Figure 9-2, p. 192).
changes related to
post-acute • Data care (PAC), is in the including datasheet. the home Make health updates IPS and in the patient datasheet. protection and Affordable Care Act of 2010
changes for other PAC services, concluded that the rate changes to payment for home health services
• WATCH FOR GLITCHY RESETS WHEN YOU UPDATE DATA!!!!
of adverse events generally improved or did not worsen
when the • IPS The was column in effect. totals A study were by added the Commission manually. In 2010, the Commission recommended that Medicare
lower home health payments to make them more
also concluded • I had that to the manually quality of draw care tick had marks not declined and axis lines consistent because with they costs, kept referred resetting to as when payment I changed rebasing. any data.
between the IPS and the PPS (Medicare Payment Advisory
• I can’t delete the legend, so I’ll just have to crop The it Patient out in Protection InDesign. and Affordable Care Act of 2010
Commission 2004). The similarity in quality of care under
(PPACA) includes several reductions intended to address
the IPS • and Use the direct PPS suggests selection that tool the payment to select reductions items for modification. Otherwise if you use the black selection tool, they
home health care’s high Medicare payments, but these
in the Balanced default Budget when you Act of change 1997 led the agencies data. to
policies may not achieve the Commission’s goal of making
reduce costs • Use and paragraph excess utilization styles without (and object a measurable styles) to format. payments more consistent with actual costs. PPACA calls
difference in the quality of patient care.
• Data was from: R:\Groups\MGA\data book for 2007\data base rate reductions book 2007 to be phased chp1 in over four years
Home health margins for freestanding HHAs have
beginning in 2014. The law sets a maximum reduction
been very high since the PPS was implemented, as of 3.5 percent a year, for a cumulative reduction of 14
Medicare margins averaged 17.7 percent between 2001
2006
2007
2008
2009
2010
Report to the Congress: Medicare Payment Policy | March 2013
191