February 2, 2018
Congress: Act now to protect rural seniors’ access to home health care
Medicare’s home health care benefit is essential to keeping aging Americans healthy at home– particularly for seniors living in rural America where health care options are limited. By enabling rural seniors to age with dignity and comfort in their own homes, Medicare is also reducing health care spending by preventing avoidable hospitalizations that drive up costs and put seniors at greater risk.
Yet, despite the tremendous value of home health to rural America, Medicare payments designed to cover the higher costs of reaching rural beneficiaries expired at the end of last year, which is why it is time for Congress to restore these vital Medicare payments.
For nearly 20 years, Medicare has recognized that providing care in non-urban areas carries higher costs because of travel and staffing expenses. To address the issue, since 2000, Congress has funded the “rural safeguard” – a 3 percent additional payment to providers to account for these higher costs. While the rural safeguard has been renewed at least five times over the past 17 years, Congress has yet to pass the “Medicare extenders” – leaving rural patients and their providers uncertain about the future.
Thanks to Medicare’s home health benefit, rural patients and their families face less of a burden when illness or injury occurs, since quality care comes to them. The value is also felt by Medicare, which saves money when patients receive prompt, thorough care to avoid costly hospitalizations.
Data show rural seniors face greater health care obstacles than their urban counterparts. According to a study by the Moran Company, the average rural Medicare beneficiary must travel twice as far to see a doctor or to reach the nearest hospital. Also, home health beneficiaries living in rural areas are also older, sicker, have lower incomes, and are living with more chronic conditions than the general Medicare population.
The rural safeguard is also essential for home health providers that deliver care in remote communities. Smaller agencies in rural America often mean smaller scale operations, and higher costs. Travel alone is 36 percent higher than in non-rural areas ($229 vs $168 per episode). Furthermore, sicker, more chronically ill rural patients are more expensive to care for – and depend heavily on home health providers as their primary caregivers. It’s a delicate system that works as it is, but that can’t withstand destabilizations in funding.
The challenges and obstacles rural home health beneficiaries already face demonstrate the critical importance of ensuring the availability of home health in underserved, rural communities across the country. Reduced access to home health, which could happen if funding is not restored, will surely force more patients in need of emergent care into more expensive care settings.
The good news is that there’s still time to restore the rural safeguard payment to support the continued delivery of quality, efficient, patient preferred home health care. I urge Congress to quickly pass the crucial Medicare extenders package, including the home health rural safeguard provision. If we wait any longer, we risk the quality, uninterrupted home health care our most vulnerable American seniors deserve.