Medicare Cost Reports: Home Health

Why is the Medicare Cost Report so important? Simple – it determines how much your agency and other agencies are going to get paid.
Reimbursement and adjustments to PPS are based on many factors, but the home health cost report data plays an important part. Specifically, MedPac, the board that makes recommendations to Congress, uses the data to track home health agency performance.


Not only does MedPac use cost report data, the group also uses information from the OIG and other government agencies. With increased fraud and abuse across the country and closer scrutiny to cost report data is occurring.  Therefore, accuracy is essential.


Many in home health thought that with the introduction of PPS, cost reports were a waste of time and filing them were nothing more than a futile exercise. In fact, the information is used for rebasing and increases to PPS, and today the data is used to determine if agencies are making too much money.


With some agency’s profit margins of 30-40% between 2008 and 2010, red flags were raised.  Not so much by smaller agencies, but by the national agencies who were cocky and smug that they were bringing in cash by the wheel barrel.  The ‘good old days’ for home health has now passed and we are now in the ‘watch your back’ era.


This new era of ADRs, RACs, ZPICs and flat out denials is here to stay.  The cost report is here to stay.  Accuracy and importance is now a must.   Think about this:  can your agency (and you) really afford to take another 2% reduction on top of the Sequester this year if your cost report is wrong or rejected?


No – of course you can’t. A home health agency is a business and making sure you are paid for the important work you do is just as important as the quality of care you provide.  A cost report proves this to MedPac and other regulatory agencies, in addition to lawmakers.


Details and accuracy are a must.  Decisions on reimbursement are based on cost report data.  If you are not properly reporting allowable costs – you could be costing your agency money in the future.  Not all agencies understand this important aspect, but you will and we are here to help.  Let us help you lead the way to a stable reimbursement.  We know you do good work and deserve to be paid for it – but now we need to let the government know that.  Call us today so we can get you going on the right track and getting that cost report done on time, accurately and without anxiety.