New Data Analysis Finds Reduced Access to Medicare Home Health

WASHINGTON – The Partnership for Quality Home Healthcare – a coalition of leading Medicare home health providers dedicated to fighting for access to quality care in the home to promote independence and health – today released a third-party analysis of Medicare home health fee-for-service claims from 2022 through 2023 demonstrating a dramatic decline in access to home health services for patients and families.

The analysis – completed for the Partnership with updated numbers from CareJourney by Arcadia – found that in 2022 alone nearly 35% of patient hospital discharges to home health failed to access home health within seven days. Further, their data show that among patients unable to access care, their rate of death was 41% higher compared to patients who received timely home health.

Specifically, the data show:

• In 2023, access to home health resulted in 34% lower hospital readmission rates.
• In 2023, 1/3 of Medicare patients (35.7%) directed to home health after a hospitalization did not access home health.
• Patients receiving home health within 7 days of discharge saw substantially lower hospital readmission rates compared to those who went home without services.
• Patients who did not access home health after hospital discharge had a 41% higher mortality rate than those who gained access to home health.
• The home health referral rejection rate has increased significantly (from 49% in 2020 to 71% in 2022), which means more patients are forced to stay in the hospital and are not able to move easily from hospital to home.

According to home health advocates, these declines are directly related to cuts to the Medicare home health base rate made in recent years.

“Looking at the fee-for-service CMS dataset for home health in recent years, researchers confirmed what the Partnership has been warning since these cuts began in 2020,” said Joanne Cunningham, CEO of the Partnership. “Annual cuts to home health have diminished the provider community’s ability to meet patient need, transfer patients home following hospitalization, and ensure home health services are accessible to Medicare beneficiaries across the country.”

For CY 2025, CMS has proposed more cuts despite reliable data demonstrating a troubling decline in the number of home health patients and patient visits. The Partnership has warned the permanent -4.067 percent payment cut to home health services proposed by CMS will further undermine the delivery of high-quality home healthcare services to millions of older Americans.

“Data confirming declines in access and poorer patient outcomes strongly suggest CMS should not implement the cut proposed for 2025,” added Cunningham. “Likewise, this raises the need for action by Congress to pass the Preserving Access to Home Health Act (S.2137/H.R. 5159) this year to stop future Medicare cuts to the home health benefit.”

To see the updated slides from CareJourney by Arcadia, CLICK HERE.

To read a November 2023 CareJourey post, How Timely Access to Home Health Care Impacts Cost and Outcomes, CLICK HERE.