- Recalibration of the Patient-Driven Grouping Model (PDGM) case-mix weights, LUPA thresholds, functional levels, and comorbidity adjustment subgroups;
- Payment adjustments to reflect the impact of differences between assumed behavior changes and actual behavior changes on estimated aggregate payment expenditures under the HH PPS;
- Creation of a permanent 5% cap on wage index decreases;
- Updates to the expanded HH value-based purchasing (VBP) program;
- Updates to the HH quality reporting program (QRP); and
- Updates to home infusion therapy rates.
Comments on the rules are due August 16 and can be made here. For more information, contact Jacob Parsons, SDAHO’s Director of Fiscal Policy.