New Analysis Finds Reduced Access to Medicare Home Health

WASHINGTON—The Partnership for Quality Home Healthcare (PQHH), a coalition of Medicare home health providers aiming to increase access to quality homecare, released a third-party analysis of Medicare home health fee-for-service claims from 2022 through 2023, which found a decline in access to home health services for patients and families.

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

“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, chief executive officer of PQHH. “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.”

Additionally, the analysis revealed: 

• In 2023, access to home health resulted in 34% lower hospital readmission rates.
• In 2023, one third of Medicare patients (35.7%) directed to home health after a hospitalization did not access home health.
• Patients receiving home health within seven 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 indicates more patients are forced to stay in the hospital and are not able to move easily from hospital to home.

The company stated that these declines are related to recent cuts in the Medicare home health base rate, according to home health advocate sources. Additionally, the Centers for Medicare and Medicaid Services (CMS) has proposed more cuts for calendar year 2025. However, the analysis by PQHH demonstrates a decline in the number of home health patients and patient visits. The company has proposed that permanent payment cuts to home health services by CMS will likely further undermine the delivery of high-quality home health care services.

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