CMS Proposes Home Health Pay Changes, Including Remote Monitoring

Skip to main content Don't miss tomorrow's healthcare industry news

Let Healthcare Dive's free newsletter keep you informed, straight from your inbox.

Daily Dive M-F Payer Weekly Every Wednesday IT Weekly Every Thursday By signing up to receive our newsletter, you agree to our Terms of Use and Privacy Policy. You can unsubscribe at anytime. Search

• Hospitals
• Payer
• Health IT
• Government
• Finances
• Medical Groups
• Telehealth

An article from Dive Brief CMS proposes home health pay changes, including remote monitoring Published July 3, 2018 Rebecca Pifer Senior Reporter

• Share
  • Copy link
  • Email
  • LinkedIn
  • X/Twitter
  • Facebook
  • Print
• License
• Add us on Google

Dive Brief:

• Centers for Medicare and Medicaid Services Administrator Seema Verma announced a slew of changes to the 2019 Home Health Prospective Payment System late on Monday, including a proposal to make the cost of remote patient monitoring an allowable cost for reimbursement.

• The proposed rule would also implement a Patient-Driven Groupings Model (PDGM) for home health payments as opposed to a Home Health Groupings Model (HHGM), which would have resulted in an estimated home health spending cut of $950 million in 2019.

• CMS estimates the proposed changes will result in increased Medicare payments to home health agencies (HHAs) of $400 million in 2019 and in a net $60 million in annualized cost savings to HHAs beginning in 2020.

Dive Insight:

The proposed changes come amid a push by all payers towards value-based care, increased competition and reduced administrative burden on physicians. The agency has already put in place proposals projected to save Medicare providers more than $144 million in 2019 and 2020, payment models tying payment to patient needs rather than volume of services provided, and more tailored Medicare Advantage plans.

The proposed rule would allow the cost of remote patient monitoring — including the cost of equipment, software and professional wages — on the Medicare cost report forms of home health agencies, an attempt to foster the adoption of new technologies and increase transparent care planning. Sharing this data will also support the Trump administration’s MyHealthEData initiative.

The PDGM update for home health payments is in line with the Bipartisan Budget Act of 2018 and, if approved, will be implemented at the start of 2020. The model would eliminate the use of "therapy thresholds" (the number of therapy visits a patient receives) in determining payment as well as change episode-of-care increments to 30 days, instead of the current 60, as therapy thresholds can promote volume over value.

Verma said that physicians ordering home health services for their patients will also see administrative burden reduced under the rule, as CMS is proposing to eliminate the requirement for physicians to estimate the length of additional skilled services and remove seven measures from the HH quality reporting program that were either unnecessary or redundant.

The update also provides information and solicits comments on the implementation of home infusion therapy temporary transitional payments, while proposing standards for home infusion therapy suppliers.

Height Commentary analyst Andrea Harris said that a lobbying push will ensue, given winners and losers in the for-profit versus nonprofit world.

"While the changes are now budget neutral, as mandated by Congress, reimbursement is projected to shift from for-profit HHAs to not-for-profit and government HHAs. We expect a major lobbying effort from the home health trade organization and changes are likely before CMS finalizes this proposal," she wrote in a note.

Recommended Reading

• New CMS database aimed at interoperability in post-acute care By Meg Bryant • June 22, 2018

• 
• 
• 
• 
• 
• purchase licensing rights

Filed Under: Payer, Government

Healthcare Dive news delivered to your inbox

Get the free daily newsletter read by industry experts

Email:

• Select Newsletter: Daily Dive M-F
• Select Newsletter: Payer Weekly Every Wednesday
• Select Newsletter: IT Weekly Every Thursday
• Select user consent: By signing up to receive our newsletter, you agree to our Terms of Use and Privacy Policy. You can unsubscribe at anytime.

Sign up A valid email address is required. Please select at least one newsletter.

Editors' picks

• 

  CMS expands audits to crack down on Medicare Advantage overpayments

  The agency said it would increase the number of MA plan audits and complete its backlog of reviews by investing in technology and growing its medical coding workforce.

  By Emily Olsen • May 22, 2025

• 

  Tracker

  The Trump administration is overhauling healthcare policy. Follow the changes here.

  The FDA said it’s sending letters to drugmakers demanding they take down or modify ads that don't comply with federal guidelines, out of concern consumers aren’t seeing a “fair balance” of risks and benefits in drug ads.

  By Healthcare Dive staff • Updated Sept. 10, 2025

Get the free newsletter

Subscribe to Healthcare Dive for top news, trends & analysis

Email:

• Select Newsletter: Daily Dive M-F
• Select Newsletter: Payer Weekly Every Wednesday
• Select Newsletter: IT Weekly Every Thursday
• Select user consent: By signing up to receive our newsletter, you agree to our Terms of Use and Privacy Policy. You can unsubscribe at anytime.

Sign up A valid email address is required. Please select at least one newsletter.

Most Popular

1. Family physicians are departing rural areas: report
2. Trump administration nixes Biden-era health IT policies, including AI ‘model cards’
3. UnitedHealth commits to changes after independent review
4. Trump administration repeals Biden-era nursing home staffing mandate

Library resources

• Playbook Boost Revenue Cycle Management with Automation and Analytics Custom content for Sutherland
• Industry Report The roadmap for building more resilient health systems Custom content for Eide Bailly
• Playbook Reinventing Credentialing: Modernize, Optimize, and Transform Custom content for Sutherland

View all

Company Announcements

View all | Post a press release

What We're Reading

• The New York Times Hospitals Cater to ‘Transplant Tourists’ as U.S. Patients Wait for Organs
• The Washington Post Health insurance is less affordable as Obamacare offerings shrink
• KFF Health News Criminally Ill: Systemic Failures Turn State Mental Hospitals Into Prisons

View all

Events

View all | Promote an event

Industry Intel

• Revenue Rescue: Closing Coverage Gaps to Strengthen Financial Health Webinar - on demand • Provided by FinThrive
• Enhance patient satisfaction and hospital operations with new Collaboration Solutions from HP and Uniguest Webinar - on demand • Provided by HP Poly
• Adopting Data-Driven Retail Strategies to Improve Member Experience Webinar - on demand • Provided by Virgin Pulse

Healthcare Dive news delivered to your inbox

Get the free daily newsletter read by industry experts

Email:

• Select Newsletter: Daily Dive M-F
• Select Newsletter: Payer Weekly Every Wednesday
• Select Newsletter: IT Weekly Every Thursday
• Select user consent: By signing up to receive our newsletter, you agree to our Terms of Use and Privacy Policy. You can unsubscribe at anytime.

Sign up A valid email address is required. Please select at least one newsletter.

Company Announcements

View all | Post a press release intive and ProVoyance™ Announce Strategic Partnership to Advance AI-Powered Orthopedic Devices From intive December 16, 2025 The Next Chapter in Obesity Therapeutics: Vial’s INHBE siRNA Draws KOL Praise as a Next‑Genera… From Vial December 16, 2025 Newgen Named a Leader in IDC MarketScape: U.S. Provider Data Management for Payers 2025–2026 V… From Newgen December 23, 2025 Cortico Surpasses 3 Million Managed Appointments as Patient Portal Adoption Surges in 2025 From Cortico December 22, 2025 Editors' picks

• 

  CMS expands audits to crack down on Medicare Advantage overpayments

  The agency said it would increase the number of MA plan audits and complete its backlog of reviews by investing in technology and growing its medical coding workforce.

  By Emily Olsen • May 22, 2025

• 

  Tracker

  The Trump administration is overhauling healthcare policy. Follow the changes here.

  The FDA said it’s sending letters to drugmakers demanding they take down or modify ads that don't comply with federal guidelines, out of concern consumers aren’t seeing a “fair balance” of risks and benefits in drug ads.

  By Healthcare Dive staff • Updated Sept. 10, 2025

Latest in Payer

• UnitedHealth commits to changes after independent review By Rebecca Pifer
• Trump administration proposes stronger insurer price transparency requirements By Sydney Halleman
• Medicare unveils successor to ACO REACH By Rebecca Pifer
• Optum Rx says 100% of network community pharmacies in cost-based contracts By Rebecca Pifer

Industry Dive is an Informa TechTarget business. © 2025 TechTarget, Inc. or its subsidiaries. All rights reserved. | View our other publications | Privacy policy | Terms of use | Take down policy. Cookie Preferences / Do Not Sell This website is owned and operated by Informa TechTarget, part of a global network that informs, influences and connects the world's technology buyers and sellers. All copyright resides with them. Informa PLC's registered office is 5 Howick Place, London SW1P 1WG. Registered in England and Wales. TechTarget, Inc.'s registered office is 275 Grove St. Newton, MA 02466. Search

• Home
• Topics
  • Hospitals
  • Payer
  • Health IT
  • Government
  • Finances
  • Medical Groups
  • Telehealth
• Deep Dive
• Opinion
• Library
• Events
• Press Releases

Get Healthcare Dive in your inbox

The free newsletter covering the top industry headlines

Email:

• Select Newsletter: Daily Dive M-F
• Select Newsletter: Payer Weekly Every Wednesday
• Select Newsletter: IT Weekly Every Thursday
• Select user consent: By signing up to receive our newsletter, you agree to our Terms of Use and Privacy Policy. You can unsubscribe at anytime.

Sign up A valid email address is required. Please select at least one newsletter.