National Alliance for Care at Home Lays Out 2024, 2025 Priorities

WASHINGTON—As 2024 starts to wind down and a new administration and Congress begins to take over in Washington, home health advocates are focused on two primary priorities: reversing planned reimbursement cuts for home health and reforming plans that target underperforming hospices. 

As Americans gather for Thanksgiving, “these are major family issues and also major national public policy issues of the highest level of strategic importance for our country,” said Dr. Steve Landers, CEO of the National Alliance for Care at Home, the organization formed by the recent merger of the National Association for Homecare and Hopsice and the National Hospice and Palliative Care Organization. 

“We’re not done with 2024 yet,” Landers said Thursday, Nov. 21. “We’ve got a lot that we want to accomplish right now, this year—and we’re looking to the future.” 

The number one priority, he said, is for Congress to intervene and stop home health payment cuts as outlined in a final rule from the Centers for Medicare and Medicaid Services (CMS). He said that the cuts would impact patient outcomes, reduce visits and hurt providers—and that they were implemented based on a Congressional mandate saying CMS should support home health.

“Instead, what CMS did was decimate the program,” Landers said. “It’s inconsistent with what Congress asked. There’s no public constituency for this. … It needs to be reversed, and it’s fixable.”

The Alliance is also focused on protecting hospice, which Landers called “a national treasure,” by limiting the effects of CMS’ hospice special focus program. The Alliance is urging the agency not to release a list that purports to include the 10% lowest performing hospices in the country, saying that the list is built on incomplete data. Katie Smith Sloan, president and CEO of LeadingAge, has also called the special focus program well-intentioned, but flawed in its current design.

“It’s likely to harm beneficiaries if it’s released, because it’s going to steer them away from quality providers. At the same time, it misses some poor performing hospices that should be flagged,” Landers said. 

Reps. Beth Van Duyne and Jimmy Panetta recently introduced the Enhancing Hospice Oversight and Transparency Act, which would increase the transparency of CMS’ data and selection processes, reduce payment for non-compliance and boost public awareness of data reporting failures.

At the same time, Landers said, The Alliance is looking forward to working with new Congressional and administration leadership to improve the outlook for homecare. He included Robert F. Kennedy Jr., the president-elect’s choice to lead the Department of Health and Human Services, and Dr. Mehmet Oz, the president-elect’s nominee to head CMS. Landers congratulated both nominees and said he likes the idea of having a physician in the CMS administrator role. 

“We want to see opportunities to grow and expand care at home as families and as many advocates hope to see,” Landers said. “As we get to engage with new officials … we will be a very visible, a very vocal partner and collaborator.”