April 15, 2015

Home Health Leaders Applaud Passage of Medicare Physician Payment Reform Legislation

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WASHINGTON – The Partnership for Quality Home Healthcare today commended Congressional leaders for passing the Medicare Access and CHIP Reauthorization Act, legislation to replace Medicare’s Sustainable Growth Rate (SGR) payment formula. Home health leaders support policies that advance value-based payment reforms, moving away from the traditional fee-for-service model.

The legislation includes a key provision to protect access to skilled home healthcare for homebound seniors residing in rural parts of America by extending the Medicare home health rural safeguard. This policy extends an additional three percent payment for home health services provided to rural patients through the end of 2017, which is needed to more fully cover the expenses of providing care in rural communities including higher travel costs.

Home health leaders did express concern, however, that Congress chose to offset a portion of the SGR legislation by cutting payments to Medicare post-acute care services, including home health. The measure limits Medicare reimbursements to home health providers scheduled for 2018 to just one percent. When compared to the typical 3.2 percent annual reimbursement increase, this market basket reduction will result in a cut of $3.4 billion over a 10-year period.

“While we are thankful for the bipartisan solution to permanently repeal SGR that includes the Medicare home health rural safeguard, we are disappointed in the restricted market basket rate for home healthcare,” stated Eric Berger, CEO of the Partnership for Quality Home Healthcare. “Our community has already been subject to a series of cuts in recent years, including the 3.5 annual rebasing cuts that continue to burden quality providers and the frail, elderly Medicare population they serve.”

This additional cut comes on the heels of 4-year, 14 percent rebasing cut to Medicare home health funding that was implemented on January 1, 2014, threatening the jobs of more than 460,000 home health professionals and the skilled care needed for 1.3 million vulnerable home health beneficiaries.

According to Avalere Health, home health seniors are the most vulnerable in the Medicare program, since they are documented as older, poorer, sicker and more likely to be disabled and of an ethnic or racial minority than all other Medicare beneficiary populations. Additionally, home health beneficiaries, the professional caregivers who serve them, and the family members who support them are disproportionately comprised of women.

“To protect homebound home health seniors from any further threats, we encourage Congress to secure savings through value-based purchasing programs that promote coordinated, patient centered care over across-the-board cuts,” added Berger. “The home health community has put forth several proposals to achieve these savings including the Securing Access Via Excellence (SAVE) Medicare Home Health Act.”

The SAVE Medicare Home Health Act would stop the rebasing cut beginning in 2016 and advance sustainable hospital readmission reforms that achieve savings by improving care for Medicare beneficiaries and reducing avoidable hospital readmissions. If enacted into law, the bill would enable millions of seniors to remain in their homes, rather than institutional settings, achieving significant savings for the Medicare program.