In 2018, Congress directed regulators to change how Medicare pays for home health services, shifting away from reimbursing for the number of therapy sessions and focusing instead on the complexity of care provided. Regulators also calculated a new 30-day episode of care down from a 60-day version.
The Patient-Driven Groupings Model went into effect in 2020, but the new payment system was intended to be budget-neutral and result in neither a net increase nor decrease in total Medicare payments. Regulators had to update payments based on how they thought home health agencies would change their practices going forward.
