If you are a therapist trying to keep up with the changes affecting your profession, your head my be spinning. In October, the therapy profession was shaken by changes which impacted skilled nursing facilities with the transition to the PDPM (Patient Driven Payment Model). Read more about this from a previous update: https://www.itaexcels.org/post/snf-reimbursement-changes-be-in-the-know.
What is next for therapists? Changes to home health reimbursement in 2020. There are significant changes in how payments will be calculated for home health agencies, which create multiple challenges in reporting requirements for HHA’s. You may not care too much what those changes are, but only want to know how that might impact you. Here is what you need to know, starting with one change that is good:
Assistants are now eligible provide maintenance therapy services. This may increase options for HHA’s to use assistants in a setting previously unable to do so.
Model of payment moves from a volume-based care to value-based care, and the number of therapy visits to be provided in a home health model is no longer used to calculate the reimbursement amount. The implication of this change is that home health agencies have been overutilizing therapy services, but will now be reimbursed, based on a patient’s condition.
A report by Home Health Care news cites a survey of 685 HHA providers, which almost half f those surveyed expecting to decrease therapy utilization in 2020 based on this reimbursement change. Significant changes in utilization, however, could trigger an audit.
The fear for therapists is that home health agencies will reduce the visits a patient will receive during a home health episode, resulting in less available work for therapists. While studies demonstrate the efficacy of therapy services in reducing hospitalizations and institutionalization, therapists seem to be facing an endless barrage of therapy reimbursement reductions.
What can you do as a therapist? The APTA emphasizes the need for therapist to collaborate with providers that are establishing the functional score used in the PDGM, so that agencies will be incentivized to continue to provide appropriate therapy services. APTA describes this as an opportunity for therapists, for education, rather than a detriment.
Stay in the know- ITA will keep you informed of the changes you need to know about.