WASHINGTON, D.C. (May 1, 2020)—More than 40% of home health agencies (HHAs) reported serving actively infected COVID-19 patients—and more than 85% in the New York/New Jersey area—in a survey conducted by the National Association for Home Care and Hospice (NAHC).

NAHC conducted the survey between April 6 and April 17; more than 1,100 home health companies from all states participated.

“The findings indicate serious concerns about the financial stability of home health agencies as operations and revenues have been severely affected in multiple ways,” NAHC reported, saying that the coronavirus pandemic has severely disrupted the care delivery system and put significant financial pressure on agencies. “The impact is due to pandemic-triggered changes affecting services to the usual 3.5 million Medicare beneficiaries who receive care in the home as well as the new patient population of COVID-19 patients.”

Nationwide, 85% of respondents reported revenue reductions, with a median reduction between 15% and 20% percent. In “hot spots” like New York and New Jersey, the reductions were even greater, with 67.9% reporting more than 15% reduction in revenue and 46.3% reporting more than 20% reduction.

Revenue reductions were mostly related to two factors: decreases in new patient admissions and patient refusal to accept all physician-ordered care to avoid virus transmission risks.

Some 79% reported decreases in admissions, with 56% indicating reductions greater than 15%. In New York/New Jersey, 92.8% of respondents reported admission reductions. Overall, 9% of agencies reported that some patients had refused care.

The report also found:

  • Refusals of all physician-ordered care have triggered payment reductions through the Low Utilization Payment Adjustment (LUPA); 67% of respondents reported at least a doubling of their LUPAs.
  • Reduction in demand and revenue have led to reduced staffing. More than half of HHAs said they had reduced clinical staff and 8% have shrunk administrative staff.
  • Respondents indicate that the top three concerns about their future are significantly reduced revenues, patient safety due to inadequate supplies of personal protective equipment and the inability to fully utilize telehealth services due to Medicare reimbursement.