Monitoring Medicare’s Home Health, Hospice, and Inpatient Rehabilitation Facility Benefits
Highlights
- CMS’s home health, hospice, and home infusion therapy, home IVIG, and IRF benefits require constant monitoring of payment policy.
- Abt uses diverse staff—including economists, programmers, clinicians, and policy experts—to perform various analyses.
- Abt has helped CMS create, implement, and monitor payment and program changes.
The Centers for Medicare & Medicaid Services’ (CMS) home health, hospice, home infusion therapy, home IVIG, and IRF benefits require constant monitoring of payment policy—and revisions, as needed—to ensure they are working as intended. This enables Medicare beneficiaries to maintain access to high-quality care, and ensures payments are aligned with the costs of providing services.
To meet the challenge, CMS has contracted with Abt Global to conduct ongoing monitoring of the utilization of these benefits and determine how changes to the payment system will impact utilization. Abt uses a diverse set of staff, including economists, programmers, clinicians, and health policy experts, to perform the varied analyses CMS needs. This project requires a deep understanding of the Medicare payment policy landscape, including its impacts on providers, consumers, and stakeholders, which Abt has developed through its long-standing work with CMS.
Abt works with CMS to make changes as necessary to the payment system to better align payment incentives with the intent of the benefit. This has included helping CMS create additional tiers of payment for hospices, and an add-on payment for services at the end of life to pay appropriately for services provided. We’ve also helped CMS create and implement a new Medicare benefit that covers service visits related to home infusion therapy. Additionally, Abt’s work has been featured in various rulemaking documents, notably:
- Hospice payment system changes (Additional tier of payment and end of life add-on payments)
- Home Health payment system change (Creation of Patient-Driven Grouping Model)
- Home Infusion therapy payment system change (Creation of benefit)
- Inpatient Rehabilitation Facility payment rate updates (Updating payment rates)
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