This past July CMS announced a proposed demonstration that would either reduce or increase a Medicare home health agency's reimbursement based on quality performance. With a rapidly aging and growing Medicare population home health utilization and costs have risen significantly over the past decade. Per MedPAC, between 2000 and 2012 total Medicare home health spending increased 64 percent. However, home health agency quality performance has been limited. For example, again per MedPAC, less than half of all Medicare home health patients in 2013 showed improvement in medication management and only 65 percent showed improvement in pain management.
During this 22 minute discussion Ms. Mason explains the several, if not numerous reasons, why CMS announced this demonstration, how it will work, e.g., how quality will be measured or what quality metrics will be used, what are the specific financial incentives, in what states the demo will be conducted, when it will begin and for how long, and what are some of the perceived pros and cons of the demonstration as proposed.
Sherill Mason is currently Principal, Mason Advisers, where she provides strategic planning, program development and operations analysis for post acute care providers including senior living and nursing home facilities, home health, hospice, long term acute care hospitals, in patient rehabilitation facilities, and long term care pharmacy. Previously, Sherill she served as a Vice Presient to the Marwood Group, a healthcare industry consultant, as Senior Vice President at Sunrise Senior Living and as a Director at KPMG. Among other current professional activities Sherill currently is a Guest Lecturer at the University of Pennsylvania School of Nursing. She received her RN diploma and training at the Englewood Hospital School Nursing and a BA in American Studies from Eckerd College.
For information regarding CMS's proposed value-based home health demonstration go to: https://www.cms.gov/center/provider-Type/home-Health-Agency-HHA-Center.html