by Amy Mayer-Barger RN, BS, COS-C
Calendar Year (CY) 2024 Home Health PPS Final Rule Posted 11/1/23
The Centers for Medicare and Medicaid Services (CMS) recently posted the Calendar Year (CY) 2024 Home Health Prospective Payment System (HH PPS) Rate Update Final Rule on November 1, 2023. The rule included routine updates to the HH PPS payment rates for CY 2024 in accordance with statutory and regulatory requirements and proposals to revise the home health market basket, which CMS describes as the mix of goods and services used in providing home health care and associated input price indexes. FAQ – Market Basket Definitions and General Information (cms.gov)
Additionally, statutory requirements to implement payment for new items and services were detailed, along finalizing changes with the expanded Home Health Value-Based Purchasing Model (HHVBP.)
Lastly, the CY 2024 HH PPS Final rule finalizes changes to the Home Health Quality Reporting Program (HH QRP):
- Addition of two quality measures and removal of one existing quality measure
- Removal of two OASIS-based data elements
- Codification of the previously finalized OASIS data completion threshold policy
- Public Reporting of four measures
- Request for information on future HH QRP measure concepts
- Update on health equity in the HH QRP
Continue reading for more details on the addition of the two new Home Health quality measures, the removal of one existing Home Health quality measure, the removal of two OASIS-based data elements and the public reporting update for four quality measures!
Home Health Quality Reporting Program (QRP) Upcoming Changes
Addition of 2 Quality Measures and Removal of 1 Existing Quality Measure
The Functional Discharge Score (DC Function) measure, which is an assessment-based outcome measure that evaluates a patient’s functional status is calculated using standardized patient assessment data from the current HH OASIS Assessment tool, begins with the CY 2025 HH QRP. This measure considers both self-care and mobility activities and accounts for missing data by using statistical imputation. HH QRP Discharge Function Score Measure – Technical Report (cms.gov)
The COVID-19 Vaccine: Percent of Patients/Residents Who Are Up to Date (Patient/Resident COVID-19 Vaccine) measure joins the HH QRP beginning with CY 2025. This measure will be reported upon the patient’s discharge from the HH agency, via assessment-based process measure data, utilizing a new item added to the HH OASIS Assessment tool HH QRP Patient COVID-19 Vaccine Measure Specifications (cms.gov).
The Application of Percent of Long-Term Care Hospital (LTCH) Patients with an Admission and Discharge Functional Assessment and a Care Plan That Addresses Function (Application of Functional Assessment/Care Plan) measure will be removed from the HH QRP beginning with CY 2025, due to measure performance among HH Agencies being topped out, and therefore, meaningful distinctions in improvement can no longer be made.
In addition, the Functional Discharge Score (DC Function) measure will replace it and is more strongly associated with desired patient functional outcomes. Public Reporting will end by January 2025, or as soon as technically feasible.
Removal of 2 OASIS-based Data Elements
Effective January 1, 2025, CMS plans to remove two OASIS items no longer necessary for data collection, M0110 – Episode Timing and M2220- Therapy Needs. Neither of these items are being used currently for payment, survey, the HHVBP Model or care planning as originally intended.
Public Reporting of 4 Measures
- Functional Discharge Score (DC Function): Public Reporting will begin January 2025, with data based on patients discharged between April 1, 2023, and March 31, 2024.
- Transfer of Health (TOH) Information to the Provider—Post-Acute Care (PAC) Measure (TOH-Provider): Public Reporting to begin with the January 2025 Care Compare Refresh, or as soon as technically feasible.
- Transfer of Health (TOH) Information to the Patient—Post-Acute Care (PAC): Public Reporting will begin with the January 2025 Care Compare Refresh, with data based on patients discharged between April 1, 2023, and March 31, 2024.
- COVID-19 Vaccine: Percent of Patients/Residents Who Are Up to Date: Public Reporting will begin with the January 2026 Care Compare Refresh, or as soon as technically feasible using data collected for Q1 2025 (January 1, 2025- March 31, 2025.)
Purchase the official CMS Final Publication
Updated for 2024, this revised CMS OASIS-E Guidance Manual is available from OASIS Answers in a convenient hard copy format. Tab dividers and a sturdy binder make it easy for your team to reference on the job. Learn More
To learn more about the full CY 2024 HH PPS Final rule, visit: Federal Register :: Public Inspection: Medicare Program: Calendar Year 2024 Home Health Prospective Payment System Rate Update; Quality Reporting Program Requirements; Value-Based Purchasing Expanded Model Requirements; etc.