CMS released its CY 2026 Home Health Proposed Payment Rule on June 30, 2025. The agency projects a 6.4% net reduction in aggregate Medicare payments to home health agencies for 2026—a decrease of approximately $1.135 billion compared to 2025. This net decrease results from several… Read More »Breaking Down the 2026 Home Health Proposed Rule
Starting July 1, 2025, home health agencies (HHAs) are required to collect and submit OASIS data for all patients regardless of payer, with a few exceptions. Here is a comprehensive guide with key things to remember and next steps to help ensure a smooth transition.… Read More »Getting Ready for July 1: All-Payer OASIS Submission
Lately, there has been a noticeable increase in denials due to invalid Face-to-Face documentation, affecting several home health agencies and raising concerns across the industry. Many of these denials seem to involve cases that came through Community Referrals. Let’s review the F2F requirements and applicable… Read More »New Insights on Face-to-Face Requirements in Home Health
Beginning July 1, 2025, OASIS data collection and submission will be mandatory for all patients regardless of payer, and home health agencies (HHAs) must be equipped to identify which patients are subject to this requirement. In the April 2025 OASIS Q&As, CMS provided several clarifications… Read More »Which Patients are Subject to All-Payer OASIS Data Collection
Effective April 1st, the April 2025 ICD-10-CM updates introduce several important changes that directly affect home health coding. Highlights include new guidance on obesity-related codes, updated documentation requirements for COVID-19, and multiple revisions to the Tabular List of Diseases and Injuries. Here’s a quick look… Read More »April 2025 ICD-10 Updates: What Home Health Agencies Need to Know
With constant changes in home health regulatory requirements, agencies face the ongoing challenge of improving patient outcomes, maintaining compliance, and optimizing reimbursements. To address this, home health agencies must streamline the documentation process at all levels to ensure accurate and thorough documentation of patient assessments… Read More »Key Foundations for Cohesive Home Health Documentation
CMS replaced the Acute Care Hospitalization (ACH) and Emergency Department (ED) Use claims-based measures with Potentially Preventable Hospitalizations (PPH) in the Home Health Value-Based Purchasing (HHVBP) Model. This transition began with the CY 2023 performance year and will affect payments starting in CY 2025. This… Read More »[HHVBP] The Shift to Potentially Preventable Hospitalizations (PPH)
CMS has published preview reports for the upcoming January 2025 Care Compare refresh. HHAs can access this preview data as part of their October 2024 Care Compare Provider Preview Report in iQIES. The January 2025 refresh of Care Compare will include three new home health… Read More »Recap: 3 New Quality Measures on Care Compare (Jan 2025)
As we approach 2025, the home healthcare industry faces significant changes in payments, compliance, and documentation requirements. This year will likely mark a pivotal point for the industry as it adapts to new challenges and opportunities. We have prepared a quick summary of the key… Read More »Preparing for 2025: Key Updates for Home Health
2024 Interim Performance Reports (IPRs) Now Available The October 2024 Interim Performance Reports (IPRs) for the expanded Home Health Value-Based Purchasing (HHVBP) Model are now available on the iQIES system. This quarterly report offers crucial information for home health agencies, including: IPRs help agencies monitor… Read More »October 2024 IPRs Out Now; HHVBP Preparations for 2025
