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by Kristin Rowan, Editor
CY 2027 Home Health PPS Final Rule
Key Changes and Industry Implications
The CY 2027 Home Health Prospective Payment System (HH PPS) Final Rule contains several important changes affecting Medicare-certified home health agencies (HHAs), their reimbursement, compliance obligations, quality reporting, and operational strategies.
Key Changes
Base pay rate
- A home health payment update of 2.1%
- A 0.3% increase for the fixed dollar loss (FLD) adjustment
- A continued -3.0% temporary adjustment from the PDGM adjustment methodology.
The 3.0% temporary adjustment was also in place in 2026. The final base pay is an estimated 2.4% net adjustment.
Medicare enrollment and fraud oversight
CMS has several changes planned to strengthen Medicare provider enrollment oversight. These changes include:
- Finalizing a policy making all Medicare enrollment revocations retroactive to the date the underlying noncompliance began
- Requiring hospices, home health agencies, and certain DMEPOS suppliers experiencing specified changes in majority ownership to reenroll in Medicare as new providers and undergo a survey or accreditation
- Expanding CMS authority to deny or revoke enrollment when owners, managing employees, or managing organizations have certain license suspensions or revocations, or suspensions from Medicaid or other federal healthcare programs
Home health quality reporting program
- Updating OASIS and HHCAHPS Annual Payment Update reporting timeframes to align with a calendar-year reporting period (January 1–December 31).
- Establishing new HH QRP assessment data submission deadlines beginning with the CY 2027 program year.
- Improving the digital exchange of information during the quality reporting program’s compliance reconsideration process.
Palliative care in home health
CMS (finally) acknowledges the important role home health agencies can play in providing community-based palliative care to patients experiencing serious or progressive illnesses. Opportunities for HHAs include:
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Developing stronger partnerships with palliative care providers
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Improving coordination between home health, hospice, and other community-based services
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Expanding staff education around symptom management and supportive care
- Identifying appropriate opportunities to serve patients with serious illnesses who are not necessarily ready for hospice
However, this provision does not establish a new standalone palliative care payment benefit or create a new reimbursement category.
Plan for the Future Now
Your agency needs to plan for the 2027 changes not only to the base pay rate, but the expanded provider enrollment provisions as well. You and your leadership team should have an action plan and a way to monitor and track implementation.
This is essential whether you own and operate a Home Health agency, provide durable medical equipment, handle medication management, or provide consulting services to an agency. There are changes in HH QRP, LUP thresholds, DME benefits and bidding program, Medicare enrollment provisions, functional impairment levels, and more.
The Rowan Report has created a Home Health Executive Guide complete with breakdowns of every change in the Final Rule, a 90-day trackable implementation plan, growth strategy, a series of worksheets, and a board meeting agenda template.
A free preview of the Home Health Executive Guide is available now.
