Bipartisan Group of Senators Send Letter to CMS Opposing Proposed Cuts to the Medicare Home Health Benefit

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 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 the Center for Medicare & Medicaid Services (CMS) expressing deep concern over possible funding cuts to the Medicare home health benefit- a vital healthcare service providing care to 3.5 million vulnerable seniors across the nation.

Earlier this year, 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. Lawmakers also caution that the most recent proposed changes from CMS are based on outdated Medicare analyses and not in line with reforms imposed on other post-acute care sectors.

The Senators write, “Unfortunately, the draft HHPPS rule proposes to cut home health payment rates further by an additional 1.72 percent in 2016. Despite CMS’s intention to adjust payments for changes in actual conditions during 2012 to 2014, the proposed rule appears to base the adjusted rate on claims from the 2000 to 2010 period. With more recent data available, we question the soundness of relying on outdated data.

“Additionally, we were pleased to see that the draft rule proposed a Home Health Value-Based Purchasing (HHVBP) program, which is an innovative concept that could hold benefits for the home health community. We are concerned, however, that the proposed incentive and penalty proposal, which could range as much as five to eight percent over a five-year period, could pose significant challenges for home health providers and their patients.”

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.

According to data compiled by Avalere, Medicare beneficiaries utilizing home healthcare 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 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 Eric Berger, CEO of the Partnership for Quality Home Healthcare. “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.”