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Implications of the Medicare Home Health Interim Payment System of the 1997 Balanced Budget Act

May 1999

National Association for Home Care
Lewin contact: Lisa Alecxih

The Medicare Home Health Interim Payment System (IPS) raises concerns for beneficiaries and providers. A temporary plan proposed until HCFA develops a home care PPS, the IPS may cause the number of home health agencies (HHAs) exceeding the Medicare cost limits to more than double and the published cost limits to decrease 21% on average overall. HHAs may operate without knowing the per-beneficiary limits for up to 6 months of the initial IPS cost reporting period. Strategies developed by HHAs to cope with this reduction may include increasing the proportion of low-end users with fewer visits and restraining costs per visit and number of visits per beneficiary. Some of these strategies could have considerable consequences for high-use home health clients.
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