December 15, 2014

Home Health Leaders Commend Congress on Budget Deal

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The Partnership for Quality Home Healthcare – a leading coalition of home health providers dedicated to improving the integrity, quality, and efficiency of home healthcare for our nation’s seniors – today commended Congress for passing a budget package that calls for further analysis of face-to-face regulations and broad funding cuts to the Medicare home health benefit.

Included in the legislation is language that requires the Centers for Medicare and Medicaid Services (CMS) to produce a public analysis regarding rebasing within 90 days of the enactment of the budget bill, and within a year, to quantify and report on the efficacy of the face-to-face requirement and how it can be simplified.

Starting on January 1, a 3.5 percent annual rebasing cut to the Medicare home health benefit began to take effect, for a total cut of 14 percent to home health providers over four years (2014-2017) as part of the Affordable Care Act (ACA). CMS itself has conceded that this cut will cause “approximately 40 percent” of home health agencies to operate at a net loss by 2017. If this cut proceeds without relief, Avalere Health has estimated that as many as 1.3 million American seniors and disabled patients who rely on skilled home healthcare to recover from a hospital stay or manage a chronic condition and an estimated 465,000 nurses and other home health professionals could be directly impacted.

Congress’ budget bill also asks CMS for further clarification about the required face-to-face certification by a physician prior to the delivery of Medicare home healthcare services and how this measure is effective in preventing fraud and controlling costs for the program.

“We are grateful to Congress for this action, which increases the focus on rebasing and regulatory challenges which confront Medicare home health patients, their skilled professional caregivers, and their families,” stated Eric Berger, CEO of the Partnership. “Our community welcomes the home health language in this budget agreement as an important step towards rebasing and regulatory relief which will stabilize access for the 3.5 million homebound Medicare beneficiaries who depend on skilled home healthcare services.”

Medicare home health patients are documented as being older, poorer, sicker and more likely to female, a minority, and disabled than the general Medicare population as a whole. Skilled home healthcare keeps these vulnerable patients in their homes and out of costly institutional settings.

Lawmakers in both the U.S. House and Senate have recognized the severity of the ACA home health rebasing cut and taken action to provide relief. In July, Representatives Greg Walden (OR-2) and Tom Price (GA-6) introduced the Securing Access Via Excellence (SAVE) Medicare Home Health Act (H.R. 5110), which repeals the arbitrary, across-the-board rebasing cut for years 2015, 2016 and 2017 and replaces them with sustainable hospital readmission reforms that achieve fully-offsetting savings by improving care for Medicare beneficiaries and reducing avoidable healthcare spending.