Hatch Tells Medicare to Slow Down Home Health Changes

The chairman of a key Senate committee is concerned Medicare is moving too quickly in making changes to payments to home health agencies.

“While I support the agency’s long-term objective of more precisely aligning Medicare payments with patient care needs … I am concerned that CMS may be rushing to finalize complex policy changes too quickly,” Sen. Orrin Hatch (R-Utah) said in a letter Sept. 22 to the Medicare agency. “Extra time and more robust data analysis is needed to assure the agency’s proposed methodology and implementation strategy achieve our shared goal of improving home health payment accuracy.” Hatch chairs the Finance Committee, which has authority over Medicare.

The letter is in reference to a July proposed rule (RIN:0938-AT01) by the Centers for Medicare & Medicaid Services that would change how and when it would pay for home health services, including nursing care. Medicare currently pays for up to 60-day episodes of care, but the CMS is proposing to use a 30-day unit in 2019. The change could result in $950 million in cuts to home health services for that year.

CMS Administrator Seema Verma said the new payment system would be more responsive to patients’ needs and would improve outcomes. “The new payment system aims to encourage innovation and collaboration and to incentivize home health providers to meet or exceed industry quality standards,” she said in a statement following the proposal’s publication.

The changes would affect the more than 10,000 Medicare-participating home health agencies in the U.S. These companies include Kindred Healthcare Inc. and HealthSouth Corp.

Comments on the proposal are due Sept. 25.

Home Health Pushes Back

The proposed changes initially received a backlash from home health agencies. William Dombi, president of the National Association for Home Care and Hospice (NAHC) in Washington, questioned whether the CMS had the authority to make such changes without legislative action from Congress.

The Partnership for Quality Home Healthcare in Washington has also pushed back against the proposal. The rule “represents a major change in both the payment and care delivery system that has not been adequately tested or validated for implementation, and it is unclear how it will impact patients. It also dramatically reduces the payment to providers,” the group said in a Sept. 21 letter to CMS Administrator Seema Verma. “This will only reduce the availability of home health services and likely increase costs to the Medicare program.”