September 19, 2011

Home Healthcare Community Applauds U.S. Representative David McKinley For Expressing Concern Over Home Health Policies that Could Have

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WASHINGTON — Members of the home healthcare community are applauding U.S. Representative David McKinley (R-1st, WV) for publicly expressing his concern that changes to the home health prospective payment system (HHPPS) could seriously impact home healthcare in West Virginia, having “ruinous consequences for patients dependent on skilled home health services and the providers who serve them.”

In a letter to Centers for Medicare and Medicaid Services (CMS) Administrator Donald Berwick last week, Rep. McKinley cites CMS’ notice of proposed rulemaking (NPRM) for 2012 under the HHPPS, in which the agency proposes to continue a series of cuts that it contends are warranted on the basis that there has been only limited change in patient acuity in past years. Providers however argue that there is strong evidence showing that patients are sicker than ever and in need of the extensive care that has markedly increased care costs.

Since 2007, CMS’ creep adjustments have totaled nearly -15 percent, including this year’s -5.06 percent of home health provider payments nationwide. According to a new analysis by the National Association for Home Care & Hospice (NAHC) and validated by the independent health care policy consulting firm, The Moran Company, CMS’ proposed policy changes would lead to negative Medicare financial margins for more than half (52.3 percent) of all home health agencies in the U.S. If the proposed rule goes unchanged, 65 percent of all West Virginia Medicare home healthcare providers would be operating in the red.

“Clearly, at a time of fiscal constraint, we should be entrusting our efficient providers like home health agencies to ensure the clinical and quality improvement of our Medicare beneficiaries”¦,” McKinley wrote. “Unfortunately, the NPRM does just the opposite: it imposes new cost pressures on efficient home health providers that will force the majority of them to operate with zero or no margin, and risk shuttering their services altogether.”

Home health care has become increasingly important to millions of American seniors who depend upon it for skilled post-acute care. Approximately 3.5 million Medicare beneficiaries annually receive home health care to recuperate from serious injury or illness at home — at a significant cost savings when compared to other care settings.

In light of what he views as an “alarming analysis,” Rep. McKinley has asked CMS to withdraw the proposed cut or consider a phased-in approach, in addition to requesting an impact analysis on rural providers who would be particularly impacted by the rule.