Home Health Leaders Call for Extension of 3 Percent Rural Safeguard

Washington, D.C. (April 26, 2017)—A new analysis of Medicare home health beneficiaries completed by The Moran Company illustrates the vulnerability of the Medicare home health patient population, particularly seniors residing in rural communities who are in poorer health and who have reduced access to health care services compared to their urban counterparts, and therefore rely heavily on home health. When compared to the total Medicare population, home health beneficiaries are older, living with more chronic conditions, in need of more assistance with daily activities and more likely to be living in poverty. When comparing home health beneficiaries, rural patients are shown to have higher prevalence of disability and poverty than home health patients residing in urban communities.

Home health leaders believe these data underscore the importance of a 3 percent rural safeguard Medicare currently pays home health providers who are delivering care to rural communities, protecting rural patients who rely on these services to remain in the home. Since 2000, the Congress has repeatedly recognized the need for a rural safeguard by extending it through various measures, which is currently set to expire on Dec. 31, 2017. 

The rural safeguard covers the additional costs per visit for patients in rural areas, which are an estimated 36 percent higher than in non-rural areas, according to a recent study by Ability. The average travel costs per rural home health episode are $229 versus an estimated $168 average for non-rural episodes.

Specific to the rural home health population, The Moran Company analysis found:

• In 2014, rural home health beneficiaries were 15 percent less likely to receive home health services than their urban counterparts (7.52 percent vs. 8.87 percent) and rural beneficiaries received fewer care episodes per 100 beneficiaries (15.52 vs. 16.81);
• 57 percent of Medicare home health beneficiaries are over the age of 75 versus 36 percent for all other Medicare beneficiaries;
• 37 percent of all rural home health beneficiaries have seven or more chronic conditions;
• Rural home health beneficiaries are 17 percent more likely to be below 200 percent of Federal Poverty Line (FPL) compared to their urban counterparts;
• Nearly a quarter of all home health beneficiaries belong to a minority; and
• Rural beneficiaries live more than twice as far from their doctor and nearly twice as far from the nearest hospital compared to beneficiaries in an urban setting.

“The disadvantages of the vulnerable rural patient population and the challenges they face when compared to their urban counterparts demonstrate the critical importance of ensuring the availability of home health in underserved, rural communities across America. Without access to home health, patients will end up receiving more emergent care in more expensive care settings, driving up costs and risking patient health,” said Keith Myers, Chairman of the Partnership for Quality Home Healthcare. “We commend the Congress for ensuring this protection for rural patients since 2000 and urge the new 115th Congress to prioritize the extension of the three percent rural safeguard to protect home health services for these patients.”

Today, approximately 3.5 million homebound seniors and disabled individuals rely on skilled home health care services, which are widely recognized as clinically advanced, cost-effective and patient preferred.

Visit homehealth4america.org for more information.