The home health care industry is constantly evolving, with new technologies, regulations, and research emerging all the time. This blog post will cover the latest news and trends affecting home health care services, with a specific focus on therapy services provided in the home.
Recent News and Updates
Several recent developments have impacted the home health care industry, particularly therapy services. Here are some key highlights:
- The Centers for Medicare & Medicaid Services (CMS) Finalizes Home Health Care Increase in 2025: CMS recently finalized the home health payment rule for 2025. While the overall estimated increase in Medicare payments to agencies is 0.5% compared to 2024, this includes a finalized 2.7% market basket increase, which is offset by the behavioral adjustment and other payment changes1. This final ruling comes after much advocacy by industry groups3. It is important to understand the Low Utilization Payment Adjustment (LUPA) in this context. LUPA is an adjusted payment for episodes with four or fewer visits during a 60-day period4.
- New Patient Acceptance Policy: CMS has finalized a new Condition of Participation (CoP) requiring home health agencies to establish a patient acceptance policy2. This policy aims to address concerns about variations in service initiation and referrals, ensuring that agencies consider factors like patient needs, caseload, staffing levels, and staff competencies when accepting new patients.
- Occupational Therapy LUPA Add-on Factor: CMS has finalized an occupational therapy (OT)-specific LUPA add-on factor2. This change ensures equitable compensation for OT services provided under the LUPA framework.
- Telehealth Extension: There are ongoing discussions in Washington, D.C. regarding the extension of telehealth flexibilities6. Republicans have proposed a three-year extension, offset by the repeal of the nursing staff mandate and reforms to Pharmacy Benefit Managers (PBMs)7. These flexibilities, implemented during the COVID-19 pandemic, have been crucial in expanding access to home health care, including therapy services.
- Investment in Home-Based Acute Care: In a sign that in-home acute care is gaining traction, Kaiser Permanente and the Mayo Clinic have announced a collective investment of $100 million in Medically Home to help expand their programs8.
Regulations and Policies Impacting Home Health Therapy
In addition to the updates mentioned above, several other regulations and policies are shaping the landscape of home health therapy:
- Permanent Prospective Adjustment and Related Legislation: CMS has implemented a permanent prospective adjustment of -1.975% to account for the transition to the PDGM3. While this adjustment is lower than initially proposed, some advocates are concerned it may unintentionally limit access to home health services for Medicare beneficiaries and contribute to high referral rejection rates3. In response to these concerns, Senators Stabenow and Collins have introduced Bill S.2137, which aims to eliminate these rate cuts9.
- Review of Home Health Value-Based Purchasing (HHVBP) Model: CMS has released preview annual performance reports for the HHVBP Model9. This model aims to improve the quality of home health care by linking payments to performance on quality measures.
- Hidden Changes in the Final Rule: It’s important to note some less prominent changes within the final rule. For instance, two claims-based measures—Acute Care Hospitalization during the first 60 days of Home Health and Emergency Department use without Hospitalization during the first 60 days of Home Health—have been removed from public reporting10.
- Behavior Assumptions in the CY 2019 HH PPS Final Rule: When implementing the home health PDGM and a 30-day unit of payment in 2020, CMS was required by law to make assumptions about behavior changes that could occur. These assumptions, finalized in the CY 2019 HH PPS final rule, included clinical group coding, comorbidity coding, and the LUPA threshold4.
- Potential for Therapist-Conducted Start of Care Assessments: CMS is seeking input on allowing registered therapists to conduct the Start of Care Assessment, even when skilled nursing is also ordered9. This change could streamline the assessment process and potentially improve efficiency.
Effectiveness of Home Health Therapy
Research continues to demonstrate the effectiveness of home health therapy in various settings:
- Improved ADL Function: A study found that patients receiving home health physical therapy showed significant improvement in their Activities of Daily Living (ADL) function11. Importantly, the likelihood of improvement increased with the number of PT visits, highlighting the impact of adequate therapy provision on patient outcomes.
- Positive Outcomes for Patients and Caregivers: Studies have shown that home health care, including therapy services, leads to positive outcomes for both patients and their caregivers12. These outcomes include improved functional abilities, reduced hospital readmissions, and increased patient satisfaction.
- Reduced Hospital Admissions: A study found that a home-based intervention program, including nursing and therapy services, led to a significant reduction in hospital admissions among older adults13.
- Effective Treatment for Acute Respiratory Failure: A case study demonstrated the effectiveness of home health physical therapy in facilitating the return to prior function for a patient with acute respiratory failure secondary to COVID-1914.
- Challenges of Clinical Reasoning in Home Health Therapy: While home health therapy demonstrates effectiveness, it’s important to acknowledge the challenges therapists face in this setting. Clinical reasoning in home health can be complex, involving numerous factors that influence decision-making, such as patient diagnosis, available resources, and the home environment. Device abandonment, where patients stop using prescribed assistive devices, is a significant concern that highlights the need for effective clinical reasoning and patient education15.
Technology and Innovations in Home Health Therapy
Technology is playing an increasingly important role in home health therapy, with innovations aimed at improving patient care and outcomes:
- Telehealth and Remote Monitoring: Telehealth services, including video conferencing and remote patient monitoring (RPM), are expanding access to care and enabling more frequent monitoring of patients’ conditions16. This can be particularly beneficial for patients with mobility challenges or those living in rural areas with limited access to in-person care.
- Artificial Intelligence (AI): AI is being used to analyze patient data, personalize treatment plans, and predict health trends17. AI-powered chatbots and apps can also provide medication reminders and support between therapy visits. This technology has the potential to not only improve patient care but also enhance job satisfaction and reduce burnout among therapists by automating tasks and providing valuable insights.
- Virtual Reality (VR): VR is emerging as a tool for physical and cognitive rehabilitation in the home19. VR-based therapy can improve balance, mobility, and strength through immersive exercises, while also engaging patients in a fun and interactive way.
- Other Emerging Technologies: Beyond telehealth, AI, and VR, other technologies are transforming rehab therapy. These include motion capture technology for precise movement analysis, video biofeedback to enhance patient awareness and control, and robotics for assisting with rehabilitation exercises20. These advancements offer exciting possibilities for improving patient outcomes and expanding the scope of home health therapy.
- Increased Use of AI and Documentation Efficiency: As home health providers increasingly adopt AI, studies are examining its potential to reduce documentation time7. This could free up valuable time for therapists to focus on direct patient care and other essential tasks.
Impact of the Latest News on Patients, Therapists, and the Home Health Care Industry
The latest news and trends in home health therapy have significant implications for various stakeholders:
- Patients: Patients benefit from increased access to care, improved quality of services, and more personalized treatment plans. Technology innovations like telehealth and VR can enhance convenience and engagement in therapy.
- Therapists: Therapists can leverage technology to provide more efficient and effective care. They can also benefit from new policies that aim to improve compensation and streamline processes. Technologies like AI and VR not only have the potential to improve patient care but also to enhance job satisfaction and reduce burnout among therapists by automating tasks and providing valuable data and insights.
- Home Health Care Industry: The industry as a whole is adapting to new regulations and embracing technological advancements to enhance the quality and efficiency of care. These changes can lead to better patient outcomes and a more sustainable future for home health care.
Conclusion
The home health care industry is undergoing a period of significant transformation, driven by new regulations, research findings, and technological advancements. These changes have a direct impact on therapy services provided in the home, with potential benefits for patients, therapists, and the industry as a whole. By staying informed about the latest news and trends, stakeholders can adapt to the evolving landscape and contribute to the continued growth and improvement of home health care.
To learn more about these developments and their implications, consider exploring the resources and links provided throughout this blog post. Share your thoughts and insights in the comments below, and let’s continue the conversation about the future of home health therapy. As these trends continue to unfold, they have the potential to reshape not only how care is delivered but also the roles and responsibilities of both patients and therapists within the home health care system.
Works cited
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2. CMS Finalizes Home Health Care Increase in 2025: CLA, accessed December 12, 2024, https://www.claconnect.com/en/resources/articles/24/cms-2025-home-health-pps-rates-policies
3. 2025 Home Health Final Rule: CMS Reduces Cuts, Revises CoPs, and More Updates, accessed December 12, 2024, https://www.medbridge.com/blog/2024/11/2025-home-health-final-rule-cms-reduces-cuts-revises-cops-and-more-updates/
4. Calendar Year (CY) 2025 Home Health Prospective Payment System Proposed Rule Fact Sheet (CMS-1803-P), accessed December 12, 2024, https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2025-home-health-prospective-payment-system-proposed-rule-fact-sheet-cms-1803-p
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11. The Impact of Home Health Physical Therapy on Medicare Beneficiaries with a Primary Diagnosis of Dementia, accessed December 12, 2024, https://pmc.ncbi.nlm.nih.gov/articles/PMC9261466/
12. The Value of Home Health Physical Therapy, accessed December 12, 2024, https://health.zeel.com/wp-content/uploads/The_value_of_home_health_physical_therapy.3-1.pdf
13. CAHPS Home Health Care Survey | Agency for Healthcare Research and Quality, accessed December 12, 2024, https://www.ahrq.gov/cahps/surveys-guidance/home/index.html
14. “The Effectiveness of Home Health Physical Therapy Following Diagnosis ” by Desiree Lyall and Maura Owens – SOAR@USA, accessed December 12, 2024, https://soar.usa.edu/casmsummer2020/4/
15. Full article: Physical therapist clinical reasoning in home care for walking assistive device prescription: A description of practice, accessed December 12, 2024, https://www.tandfonline.com/doi/full/10.1080/09593985.2021.1996495
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17. The Future Is Now: How Smart Technology Is Transforming Home Health Care, accessed December 12, 2024, https://www.trusthomecare.info/smart-tech-is-transforming-home-health-care/
18. The Future of Home Healthcare: How Technology is Shaping the Industry – Branch, accessed December 12, 2024, https://www.branchapp.com/blog/how-technology-is-shaping-home-health-care
19. The Future of Home Care: 9 Technologies Revolutionizing Aging in Place, accessed December 12, 2024, https://thekrauseagency.com/professional-tips/future-of-home-care-technology/
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