On September 18, 133 Members of the U.S. House of Representatives, from both sides of the aisle, delivered a letter to CMS Acting Administrator Andy Slavitt expressing their deep concern with proposed Medicare home health funding cuts. On September 24, a bipartisan group of Senators followed up with their own letter expressing the same concerns in even stronger language.
With regard to CMS's proposed HHPPS rule for 2016, which would cut an additional $350 million from the Medicare program's home healthcare benefit on top of the 14 percent rebasing cut imposed in January 2014, the House letter stated, "First, we are concerned with the draft HHPPS rule's proposal to cut home health payment rates by an additional 1.72 percent in 2016 and again in 2017. This proposed 'case mix' reduction is of concern because it appears to be based on a 2000-2010 case mix weight change analysis rather than changes in the condition of beneficiaries during the 2012 to 2014 period that Medicare proposes to address."
The Senate's letter expressed the same objection and added, "With more recent data available, we question the soundness of relying on outdated data."
The House letter also expressed the opinion that implementing a Home Health Value-Based Purchasing program that accelerates a 5 percent withhold to 8 percent over only three years "is too much too fast," adding, "If the rule goes into effect as proposed, it is estimated that nearly half of all home health agencies operating in the United States will report a net loss by 2017, forcing many to close their doors, jeopardizing healthcare access for millions of seniors and threatening the jobs of thousands of healthcare professionals."
The lawmakers are concerned that rural HHAs and the beneficiaries they serve are at the most risk, especially should the only agency in a region be forced to close. "In areas where there is only one HHA (26 U.S counties, according to an Avalere Health analysis), data suggest closures will likely force patients to seek care in more expensive institutional settings or, far worse, avoid treatment all together," the House letter stated.
Also from the Avalere Health report, Medicare's 3.5 million home health beneficiaries are older, sicker, poorer and are more likely to be female, a minority, and disabled than all other beneficiaries in the Medicare program combined.
The Partnership for Quality Home Healthcare – a coalition of home health providers dedicated to improving the program integrity, quality, and efficiency of home healthcare for our nation's seniors – applauded Senators Susan Collins (R-ME), Pat Roberts (R-KS), Chuck Schumer (D-NY), and Debbie Stabenow (D-MI) for their leadership in sending a letter to CMS expressing their deep concerns.
"We applaud Senators Collins, Roberts, Schumer and Stabenow for their efforts to protect Medicare benefits for the millions of seniors who rely on clinically advanced home healthcare," stated Partnership CEO Eric Berger. "We respectfully ask CMS to consider the concerns being expressed from both sides of the aisle and look forward to working with both Congress and the Administration to enact policies that are both patient centered and cost-effective."
The Partnership for Quality Home Healthcare was established in 2010 to assist government officials in ensuring access to skilled home healthcare services for seniors and disabled Americans. Representing community- and hospital-based home healthcare agencies across the United States, the Partnership is dedicated to developing innovative reforms to improve the quality, efficiency and integrity of home healthcare.
©2015 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan's Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. firstname.lastname@example.org