A First Look at Shifts in Community-Entry Home Health Following Medicare Payment Reform

Medicare-funded home health (HH) provides short-term nursing, physical therapy, and other services to over 3.5 million older adults each year. Currently, half of HH episodes are “community-entry,” meaning the patient was referred without an immediately preceding hospitalization. The 2020 implementation of a new payment system—the Patient-Driven Groupings Model (PDGM)—reduced traditional Medicare reimbursement for community-entry HH (CEHH). We investigated shifts in CEHH care delivery following PDGM implementation.