Stop Home Health Rate Cuts!
Medicare Home Health has endured a series of massive cuts to the reimbursement structure and providers are expecting additional cuts to be announced in this years rulemaking by the Centers for Medicare & Medicaid Services (CMS). These cuts will have devastating, long-term repercussions on access to care for patients, and it is estimated that more than half of Medicare-certified home health agencies will be operating with negative margins as a result of these cuts.
It is crucial for Congress to intervene and tell CMS to stop these additional cuts. The 7.85% permanent cut finalized in 2022 equates to more than $1 billion in cuts annually starting in 2024 and continuing in perpetuity. This will result in devastating, long-term repercussions for home health patients and their providers.
Moreover, these cuts will total more than $18 billion over the next ten years – even more than what CMS originally proposed. CMS finalized these cuts last year despite strong opposition from patients, providers, and lawmakers. Medicare providers and the elderly, disabled, and chronically ill patients they serve rely on Medicare FFS payments to cover the costs of care. FFS Medicare margins offset below-cost payment rates for Medicare-covered home health services provided to Medicare Advantage enrollees and Medicaid beneficiaries. While this subsidization is not optimal, it has worked to ensure that all Medicare and Medicaid beneficiaries are able to access care by quality home healthcare providers.
Home health is broadly preferred by Medicare beneficiaries, helping patients avoid hospital visits and nursing homes stays. The immediate damage to home healthcare providers is evident, with MedPAC estimating that Medicare FFS operating margins will drop by 7 percentage points, and overall payer margins will drop to the low single digits with just the 2023 cuts in place. With the upcoming full rate reduction, the average overall margin will fall below zero, threatening access to home health services, especially in rural and hard-to-reach communities.
CMS ignored data and recommendations from home health leaders warning that the agency’s methodology for justifying these cuts is deeply flawed and in violation of CMS’ statutory authority. For two rulemaking cycles, CMS has refused to alter its approach for calculating budget neutrality under the 2018 Bipartisan Budget Act and instead has continued with a methodology that inflicts significant disruption and uncertainty on the vital home health benefit.
It is time for Congress to act and tell CMS to stop these additional cuts to home healthcare in 2024. These cuts will threaten the ability of 3.2 million Medicare beneficiaries to receive life-saving clinical care in the home each year. It is time to prioritize the health and well-being of our elderly, disabled, and chronically ill patients and ensure that they have access to the care they need and deserve.
Stop Home Health Rate Cuts!
Medicare Home Health has endured a series of massive cuts to the reimbursement structure and providers are expecting additional cuts to be announced in this years rulemaking by the Centers for Medicare & Medicaid Services (CMS). These cuts will have devastating, long-term repercussions on access to care for patients, and it is estimated that more than half of Medicare-certified home health agencies will be operating with negative margins as a result of these cuts.
It is crucial for Congress to intervene and tell CMS to stop these additional cuts. The 7.85% permanent cut finalized in 2022 equates to more than $1 billion in cuts annually starting in 2024 and continuing in perpetuity. This will result in devastating, long-term repercussions for home health patients and their providers.
Moreover, these cuts will total more than $18 billion over the next ten years – even more than what CMS originally proposed. CMS finalized these cuts last year despite strong opposition from patients, providers, and lawmakers. Medicare providers and the elderly, disabled, and chronically ill patients they serve rely on Medicare FFS payments to cover the costs of care. FFS Medicare margins offset below-cost payment rates for Medicare-covered home health services provided to Medicare Advantage enrollees and Medicaid beneficiaries. While this subsidization is not optimal, it has worked to ensure that all Medicare and Medicaid beneficiaries are able to access care by quality home healthcare providers.
Home health is broadly preferred by Medicare beneficiaries, helping patients avoid hospital visits and nursing homes stays. The immediate damage to home healthcare providers is evident, with MedPAC estimating that Medicare FFS operating margins will drop by 7 percentage points, and overall payer margins will drop to the low single digits with just the 2023 cuts in place. With the upcoming full rate reduction, the average overall margin will fall below zero, threatening access to home health services, especially in rural and hard-to-reach communities.
CMS ignored data and recommendations from home health leaders warning that the agency’s methodology for justifying these cuts is deeply flawed and in violation of CMS’ statutory authority. For two rulemaking cycles, CMS has refused to alter its approach for calculating budget neutrality under the 2018 Bipartisan Budget Act and instead has continued with a methodology that inflicts significant disruption and uncertainty on the vital home health benefit.
It is time for Congress to act and tell CMS to stop these additional cuts to home healthcare in 2024. These cuts will threaten the ability of 3.2 million Medicare beneficiaries to receive life-saving clinical care in the home each year. It is time to prioritize the health and well-being of our elderly, disabled, and chronically ill patients and ensure that they have access to the care they need and deserve.