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 DiveM-F
Select Newsletter:Payer WeeklyEvery Wednesday
Select Newsletter:IT WeeklyEvery 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
Anna Moneymaker via Getty Images
Stopping a ‘moral obscenity’: Senate Judiciary Committee expresses support for PBM reform
Sen. Chuck Grassley, R-Iowa, suggested Congress could once again move to overhaul PBMs’ controversial business practices after legislators pass President Donald Trump’s conservative megabill this summer.
By Rebecca Pifer • May 14, 2025
Kevin Dietsch/Getty Images via Getty Images 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 DiveM-F
Select Newsletter:Payer WeeklyEvery Wednesday
Select Newsletter:IT WeeklyEvery 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
Family physicians are departing rural areas: report
Trump administration nixes Biden-era health IT policies, including AI ‘model cards’
HHS seeks input on speeding AI adoption in clinical care
UnitedHealth commits to changes after independent review
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
Scalable Patient Collaboration and Engagement Webinar - on demand•Provided by HP Poly
Revenue Rescue: Closing Coverage Gaps to Strengthen Financial Health Webinar - on demand•Provided by FinThrive
Mastering Claim Management: How Piedmont automated 90% of status inquiries Webinar - on demand•Provided by Waystar
Healthcare Dive news delivered to your inbox
Get the free daily newsletter read by industry experts
Email:
Select Newsletter:Daily DiveM-F
Select Newsletter:Payer WeeklyEvery Wednesday
Select Newsletter:IT WeeklyEvery 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 Cortico Surpasses 3 Million Managed Appointments as Patient Portal Adoption Surges in 2025 From Cortico December 22, 2025 Overjet Announces New FDA Clearance for CBCT 3D Imaging From Overjet December 16, 2025 Flash Renews HITRUST Certification From Flash December 17, 2025 Clinical Education Alliance Becomes Decera Clinical, Delivering Education, Insights, and Commu… From Decera Clinical December 17, 2025 Editors' picks
Anna Moneymaker via Getty Images
Stopping a ‘moral obscenity’: Senate Judiciary Committee expresses support for PBM reform
Sen. Chuck Grassley, R-Iowa, suggested Congress could once again move to overhaul PBMs’ controversial business practices after legislators pass President Donald Trump’s conservative megabill this summer.
By Rebecca Pifer • May 14, 2025
Kevin Dietsch/Getty Images via Getty Images 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