Sunday, July 17, 2011

CMS & Home Health Demos

CMS recently announced that it will share nearly $15 million in additional savings with more than 100 Home Health Agencies (HHA) participating in the two year “Medicare Home Health Pay for Performance” (HHP4P) demonstration. The HHP4P demonstration conducted between January 2008 and December 2009 was undertaken to determine the impact of financial incentives on improving the quality of care for home health patients and how the savings would impact on overall Medicare costs.

A total of 123 HHAs out of 270 participating in the demonstration intervention group will receive incentive payments from savings based on their performance during the second year of the demonstration. In year one, 166 intervention group agencies in three regions received payments totaling more than $15 million. For year 2, the demonstration calculated aggregate savings of $14.95 million for two of the four demonstration regions. The Midwest and the Northeast regions did not achieve any savings and were not eligible to receive incentives. The demonstration is still being evaluated with additional results expected later in 2011.

To address chronic conditions, CMS will conduct their “Independence at Home Demonstration” slated to begin January 1, 2012 as mandated by the Affordable Care Act. Over three years, the demonstration will test a payment incentive and service delivery model using physician and nurse practitioner directed home-based primary care teams to improve health outcomes.

The demonstration is designed to allow Medicare beneficiaries with multiple chronic conditions to live independently in their homes and avoid unnecessary and costly hospitalizations, emergency room visits, and nursing home admissions.

The demonstration is to take place in high-cost areas, use health professionals that have experience in furnishing healthcare services to applicable beneficiaries in the home, use EMRs, health information technology, and provide individualized plans of care.