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The Centers for Medicare & Medicaid Services June 30 issued its calendar year 2026 for the home health prospective payment system. This rule would reduce HH payments by an estimated 6.4%, or $1.13 billion, in CY 2026 relative to 2025. This update includes a 3.2% market basket update, reduced by a 0.8 percentage point cut for productivity. The rule also includes several reductions that CMS proposes as necessary to achieve budget neutral implementation of the Patient-driven Groupings Model. These are a 4.1% permanent reduction to the standard payment rate to prevent future overpayments, as well as a temporary but indefinite 5.0% reduction to recoup past overpayments. CMS also proposes a 0.5% reduction related to high-cost outlier payments. These negative payment updates come on top of numerous other reductions in recent years; as such, AHA has expressed ongoing concern about the impact these cuts may have on access to care for patients, including those being discharged from hospitals. 
 
For the Home Health Quality Reporting Program, CMS proposes to remove the measure assessing the percentage of patients receiving COVID-19 vaccinations. The agency also would remove four standardized patient assessment data elements focused on living situation, food and utilities. The rule also includes requests for information on changing the data submission deadline for HH QRP data, advancing digital quality measures and new measure concepts for the HH QRP. CMS also proposes to add four new measures to the HH Value-Based Purchasing Model — Medicare Spending per Beneficiary, and three measures assessing patient functional improvement in dressing and bathing.  
 
CMS will accept comments on the proposed rule for 60 days following publication in the Federal Register. AHA members will receive a Special Bulletin with additional details on the rule in the coming days.