Listen now (23 mins) | Listen Now 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.