CMS proposes to expand the Home Health Value-Based Purchasing Model nationwide

Public and private providers are keen on expanding their home health programs after seeing how well it worked during the pandemic.

The Centers for Medicare and Medicaid Services has issued a proposed home health rule aimed at accelerating the shift to value by expanding the Home Health Value-Based Purchasing Model nationwide.
The CY2022 Home Health Prospective Payment System proposed rule provides payment updates that would increase Medicare payments to home health agencies by an aggregate of 1.7%, or $310 million.

This increase reflects the effects of the proposed 1.8% home health payment update percentage ($330 million increase) and a 0.1% decrease in payments due to reductions made in the rural add-on percentages mandated by the Bipartisan Budget Act of 2018.

Along with routine updates to the Home Health Prospective Payment System, CMS proposes home infusion-therapy services payment rates for 2022, as well as making permanent changes to the home health conditions of participation implemented during the COVID-19 pandemic.

The proposed rule also seeks feedback on ways to attain health equity for all patients through policy solutions, including enhancing reports on Medicare/Medicaid dual eligible and disability status.

In addition, the proposal seeks ideas on providing care for people who live in rural areas, the LGBTQ+ population, religious minorities and groups who would otherwise be adversely affected by persistent poverty or inequality.

The CMS Innovation Center (CMMI) developed the model, which began in select states in January 2016, to determine whether payment incentives for providing better quality of care with greater efficiency would improve the quality and delivery of home healthcare services to people with Medicare.

Public and private healthcare providers alike are keen on expanding their home health programs after seeing how well it worked during the pandemic, including its ability to lower costs by keeping patients out of the hospital. Having a medical home platform, for example, helps to manage care and avoid unnecessary ER visits. Each patient a provider is able to treat by telehealth at home represents potential avoidance of a costly ER visit or hospital stay.

Humana recently acquired One Homecare Solutions to expand its presence in the value-based home healthcare space. 

Technological developments, including the digitalization of healthcare and growing availability of IoT devices that can be used for remote patient monitoring, play a role here, as does the consumerization and digitalization of healthcare.


Metro Health recorded a 95% patient satisfaction rate among COVID-19 patients enrolled in their telehealth and RPM program. Their program also showed that cultivating patient feedback – which can be incorporated into the telehealth program – provides the key data metrics that allow providers to further improve quality and programs on offer.

In addition to an increased focus on home health, the digital health industry is seeing a growing focus on LGBTQ+ health, with LGBTQ+-focused companies boosting their total funding to $39 million, according to Rock Health’s estimates.


“Homebound Medicare patients face a unique set of challenges and barriers to getting the care they need,” CMS Administrator Chiquita Brooks-LaSure said by statement. “Today’s announcement is a reaffirmation of our commitment to these older adults and people with disabilities who are counting on Medicare for the healthcare they need. This proposed rule would streamline service delivery and value quality over quantity – at a time when Americans need it most.”