133 Members of Congress Send Letter to CMS Expressing Concern with Proposed Medicare Home Health Funding Cuts

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 – today applauded 133 Members of the U.S. House of Representatives for expressing their deep concern with proposed Medicare home health funding cuts in a letter to the Centers for Medicare & Medicaid Services (CMS) Acting Administrator Andy Slavitt.

In June, CMS released the Home Health Prospective Payment System (HHPPS) proposed rule for 2016, in which the agency proposes to cut an additional $350 million from the Medicare program’s home healthcare benefit on top of the 14 percent rebasing cut imposed on the home health benefit in January 2014. Home health leaders warn that the most recent proposed changes from CMS are based on outdated Medicare analyses, appear to be out of step with reforms imposed on other post-acute care sectors, and put an even greater number of Medicare beneficiaries, agencies and healthcare jobs at risk.

The bipartisan lawmakers write, “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.

“Second, the draft rule proposes a Home Health Value-Based Purchasing (HHVBP) program that would impose an incentive/penalty range of as much as 5 to 8 percent over a 5-year period. We are very concerned with the aggressive nature in which the Secretary intends to ramp up HHVBP. Implementing a VBP program with a 5 percent withhold that increases to 8 percent just three years later is too much too fast. “

The lawmakers further warn that the proposed Medicare cuts will put small and rural home health agencies (HHAs) – and the homebound beneficiaries they serve – at greatest risk. In areas where there is only one HHA, data suggest closures will likely force patients to seek care in more expensive institutional settings or, far worse, avoid treatment all together. According to an analysis by Avalere Health, more than 631,000 Medicare beneficiaries in nearly 2,000 rural counties relied on home healthcare services in 2013.

Home health leaders underscore that additional cuts will negatively impact Medicare’s most vulnerable patient population. Data also compiled by Avalere Health reveal that 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.

“We applaud Representatives Greg Walden, Tom Price, Earl Blumenhauer and James McGovern for their leadership on this important senior care issue and thank their 129 House colleagues for taking action to protect seniors’ access to vital home health services,” stated Eric Berger, CEO of the Partnership for Quality Home Healthcare. “We urge CMS to carefully review the lawmakers’ concerns and we look forward to our continued work with both Congress and CMS to ensure policies are put forth that protect cost-effective and clinically advanced healthcare services for seniors in the setting they prefer – their home.”

Medicare home health is defined as medical care provided in a patient’s home and can include skilled nursing care, physical therapy, occupational therapy and speech therapy. Today, approximately 3.5 million American seniors rely on the Medicare home health benefit for care. According to a recent Bring The Vote Home poll conducted by Morning Consult, more than nine in 10 seniors (94%) across gender age and region favor Medicare coverage of home healthcare services.