Policy & Regulation News

CMS Releases Fee-for-Service Data for Home Health Agencies

“CMS has been a pioneer in greater data transparency and views it as key to a more effectively functioning health care system where information flows more freely.”

By Jacqueline DiChiara

- The Centers for Medicare & Medicaid Services (CMS) is striving once again to make the healthcare industry more  transparent, affordable, and accountable with the dissemination of free-flowing information.

the Home Health Agency PUF Medicare beneficiaries

CMS has released a public data set with information on services home health agencies provide to Medicare beneficiaries – The Home Health Agency Utilization and Payment Public Use File (Home Health Agency PUF). 

This new data set includes information about utilization, payments, and submitted charges.

Information is categorized into four segments: aggregated information by provider, aggregated information by provider and Home Health Resource Group (HHRG), aggregated information by HHRG, and aggregated information by HHRG by state.

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  • “The Home Health Agency data made available today focuses on our initiative of achieving better care, smarter spending, and healthier people throughout our health care system,” stated Andrew Slavitt, CMS Administrator.

    “CMS has been a pioneer in greater data transparency and views it as key to a more effectively functioning health care system where information flows more freely.”

    The Home Health Agency PUF originated from CMS administrative claims data. The 2013 data is based on home health agency Part A institutional claims. 

    Information is available for over 11,000 home health agencies, over 6 million claims, and over $18 billion in 2013 Medicare payments.

    Said CMS, the new data is “part of the Obama Administration’s efforts to make our healthcare system more transparent, affordable, and accountable.”

    Highlights from CMS's Home Health Agency data cost comparisons

    The episode average standardized payment for all HHAs nationwide was over $3,000. The Southeast and Mountain states had the highest average per episode rates nationwide. The Southwest, Midwest, and West coast had the lowest per episode rates.

    The Southwest and Florida generally had “much higher” payments compared to other states, CMS found. The average standardized payment per beneficiary topped $800 in Texas, Oklahoma, Florida, Louisiana, and Mississippi. This amount was less than $200 in Montana, North and South Dakota, Wyoming, Alaska, and Hawaii.

    Regarding outlier payments by state in 2013, Utah, New York, and Florida all had quite high levels as a percent of total payments. Many of the HHAs in these 3 states had the maximum 10% the law allows, CMS said. Lower percentages were noted across the Southeast and Midwest.

    CMS's vision of a stronger industry continues

    Last month, CMS estimated a $260 million reduction in home health agency Medicare payments via a series of rule provisions for the upcoming year.

    “Provisions in these rules will help move the nation’s [healthcare] system to one that values quality over quantity and focuses on reforms such as measuring for better health outcomes, helping patients return home, managing and improving chronic diseases, and fostering a more-efficient and coordinated health care system,” CMS asserted.

    Nearly 3.5 million beneficiaries in 2013 received home health services among nearly 12,000 home health agencies to the stunning financial tune of almost $18 billion.