The Centers for Medicare and Medicaid Services (CMS), Washington, recently issued a report conducted by ABT Associates outlining its analysis of case-mix change for 2006 to 2007, says a statement from the American Physical Therapy Association (APTA), Alexandria, Va.
The report offers greater insight into the methodology CMS used when it adjusted payment rates in the fiscal year 2008 home health prospective payment system (HH PPS), says the statement.
Under the home health prospective payment system, each patient admitted to home health is evaluated and assigned to one of 153 case-mix groups (also known as home health resource groups or HHRGs). According to the report, CMS has seen a 15.03% increase in the case-mix from 2000 through 2007.
CMS has been attempting to determine whether the increase in the case-mix is based on changes in patient characteristics or changes in coding practices, says the statement. In 2005, CMS found that only 8% of case-mix growth could be explained by changes in patient characteristics. In 2006 and 2007 CMS notes a continued trend in case-mix growth. This report analyzes those trends and gives further explanation of what data and methodology was used by CMS to make the current reductions in payments to the HH PPS.