What distinguishes Home Health Agency (HHA) PPS from IPPS?

• A. HHA PPS reimburses per-visit per patient with case-mix adjustments; IPPS reimburses per inpatient discharge with DRG-based rates.
• B. HHA PPS uses DRG-based per-discharge payments; IPPS uses per-visit per-patient.
• C. HHA PPS is per diem with no case-mix; IPPS is fixed per stay.
• D. HHA PPS uses per-visit with no adjustments; IPPS uses random rates.

Answer: (A)

The key idea is how each system determines payment. Home Health Agency (HHA) PPS pays based on the visits you deliver to a patient, with adjustments made for the patient’s characteristics and expected care needs (case-mix). In other words, you get paid per visit, but the total rate is adjusted to reflect how complex or resource-intensive the patient is. In contrast, inpatient prospective payment (IPPS) pays a fixed amount for each hospital admission, determined by the diagnosis-related group (DRG) the patient’s case falls into. DRG-based rates group similar inpatient cases that are expected to use similar resources, and the payment is tied to the discharge, not the number of visits.

So the best answer states that HHA PPS uses per-visit payments with case-mix adjustments, while IPPS uses per-inpatient-discharge payments based on DRGs. The other options mischaracterize the payment structure or the adjustments involved.