2008 refinements to the Medicare Home Health Prospective Payment System

Home Healthc Nurse. 2008 Mar;26(3):181-4. doi: 10.1097/01.NHH.0000313351.08852.9f.

Abstract

On January 1, 2008, Centers for Medicare and Medicaid Services (CMS) implemented refinements to the Prospective Payment System (PPS). This is the first change to the way CMS reimburses Medicare patients receiving home health services since the inception of PPS in 2000. The calculation for the exact episode payment has changed significantly, but from a clinical management perspective, the focus must be on ensuring that both the Outcome and Assessment Information Set (OASIS) assessment and the International Classification of Diseases (ICD)-9 CM coding are completed accurately-the same things all clinicians should be doing currently! This article will describe the structural, payment adjustment, and base rate changes for Medicare home care reimbursement that were implemented by CMS on January 1, 2008.

MeSH terms

  • Diagnosis-Related Groups / organization & administration
  • Episode of Care
  • Home Care Services / organization & administration*
  • Humans
  • Insurance Claim Reporting
  • Medicare / organization & administration*
  • Needs Assessment
  • Nursing Assessment
  • Organizational Innovation
  • Outcome Assessment, Health Care
  • Prospective Payment System / organization & administration*
  • United States