Coming Changes to Medicare PPS

Stephen Tweed | October 15, 2006 | Newsroom
Mary St. Pierre, Vice President for Regulatory Affairs brought us up to date on the proposed changes to Medicare PPS. CMS wants to create a "more equitable distribution of funds."Some of the changes:Adjustments to SCIC, PEP, and LUPAsAdjustments to reimbursement for Medical SuppliesRevisions to the Case MixCase Mix Revisions include:Diagnosis and co-morbidityA "4 equation model"Multiple…

Mary St. Pierre, Vice President for Regulatory Affairs brought us up to date on the proposed changes to Medicare PPS. CMS wants to create a “more equitable distribution of funds.”

Some of the changes:

  • Adjustments to SCIC, PEP, and LUPAs
  • Adjustments to reimbursement for Medical Supplies
  • Revisions to the Case Mix

Case Mix Revisions include:

  • Diagnosis and co-morbidity
  • A “4 equation model”
  • Multiple therapy thresholds
  • Smoothing between thresholds

The target is to have these revisions implemented by January of 2008, which means the proposed rule will be drafted by January 2007, have a 60 day comment period, and write the final rule by July or August 2007. Stay tuned to NAHC or your state home care association for more updates on these revisions.

What are your thoughts on the proposed PPS changes? Add your comments below.

Stephen Tweed
Stephen Tweed is among the top Thought Leaders in Home Care today. As an industry researcher, author, and executive coach, he has worked with owners and CEOs of companies in the top 5% of Home Care and is a frequent speaker at Home Care association conferences and corporate meetings across the US and Canada.

Related Posts

Shared Vision Can Change Your Life

August 21, 2025
This past week, I was in Fort Myers, FL leading an Executive Strategy Retreat for a wonderful family-owned Home Care company. We spent a full day using the storyboarding technique from the Walt Disney organization to stimulate creativity, make ideas visible, and craft a five-year vision for the company. We then dug into detail as we defined…
Read more

Corporate Culture in Home Care

August 7, 2025
I've been thinking a lot about Corporate Culture in Home Care For the past few weeks, I've been deeply immersed in the final preparation for the start of school. As you may have heard, I recently accepted a position as Adjunct Instructor of Corporate Culture in the Master of Arts in Communication and Business Leadership at High Point…
Read more

Appreciation and Recognition

July 31, 2025
This past Tuesday evening I was in Scottsdale, AZ for the annual CPAE Speaker Hall of Fame Awards, and the Cavett Award, presented by the National Speakers Association. This is the final formal banquet that brings to a grand finale the annual convention of NSA. The National Speakers Association is a society of experts who speak professionally. These are some of…
Read more