Estimated Impacts of Multiple Payment Policies on Rural-Serving Home Health Agencies


  • Abstract

    This study estimated the potential impacts on rural-serving home health agencies (HHAs) of three recent Medicare payment policy changes:
    • The Patient Driven Groupings Model (PDGM) was implemented in 2020 and replaced Medicare’s original prospective payment system with a new model that focuses more on patients’ clinical characteristics at home health admission and uses shorter 30-day payment periods compared to the prior model.
    • Rural add-on payments, which provided percentage-based increases in payments made to HHAs for serving rural beneficiaries, were revised based on county-level service utilization and population density starting in 2019, and then gradually decreased annually through 2022 before sunsetting at the end of 2023.
    • The Home Health Value Based Purchasing (HHVBP) model, which provides a percentage increase or decrease in all payments to HHAs based on overall quality scores, was launched as a demonstration in nine states in 2016 and expanded nationwide in 2022.


  • Authors:

    Mroz TM, Garberson LA, Andrilla CHA, Patterson DG

  • Journal/Publisher:

    WWAMI Rural Health Research Center, University of Washington

  • Edition:

    Jul 2024.

  • Documents:

    Report

  • Citation:

    Mroz TM, Garberson LA, Andrilla CHA, Patterson DG. Estimated Impacts of Multiple Payment Policies on Rural-Serving Home Health Agencies. Report. WWAMI Rural Health Research Center, University of Washington; July 2024

  • Related Studies:

    Examining the Potential Impact of Multiple Payment Policies on Rural versus Urban Home Health Agencies