The National Association for Home Care & Hospice (NAHC) and the Partnership for Quality Home Healthcare (the Partnership) commended Senators Debbie Stabenow (D-MI) and Susan Collins (R-ME) for introducing the Preserving Access to Home Health Act of 2023 to safeguard access to essential home-based, clinically advanced health care services by preventing the Centers for Medicare & Medicaid Services (CMS) from implementing dire cuts of negative -7.85% to the Medicare Home Health Program, which translates to more than $18 billion over the next decade.
Specifically, the bill is designed to address deep cuts made to home health by CMS during the implementation of the Medicare home health payment system—Patient-Driven Groupings Model or PDGM—by making the following policy changes:
- Repeals permanent and temporary payment adjustments. The bill would repeal the requirement that CMS make determinations related to the impact of behavior changes on estimated aggregate expenditures and would eliminate CMS’s authority to adjust home health payments based on such determinations under PDGM. This change would take effect and be implemented as if it was included in the Bipartisan Budget Act of 2018 that included home health provisions leading to PDGM implementation.
- Instructs MedPAC to analyze the Medicare Home Health Program. The bill instructs MedPAC to review and report on aggregate trends under Medicare Advantage, Medicaid and other payers, and consider the impact of all payers on access to care for Medicare home health beneficiaries. To verify MedPAC’s calculations, the Commission would be required to make its calculations public. This provision would also add requirements for Medicare home health cost reports to include data on visit utilization and total payments by program to facilitate this MedPAC analysis.
“We strongly support this essential legislation as current policy positions of CMS put access to home health services for the over three million beneficiaries that utilize this care in jeopardy,” said NAHC President William A. Dombi. “The Medicare home health benefit has shrunk over the last decade due to various payment cuts, which the most recent of those is the subject of the legislation. We call on both houses of Congress to join Senator Stabenow and Senator Collins in their valiant effort to preserve the home health benefit.”
According to NAHC and the Partnership, the Preserving Access to Home Health Act of 2023 is immediately needed to protect the future viability of the Medicare home health program which more than 3 million older Americans rely on annually. When considering the legislation, home health leaders urge lawmakers to consider:
- The Congressional Budget Office (CBO) projects Medicare home health spending to drop at an alarming rate. CBO projects Medicare Home Health spending will drop from $18 billion previously to $16 billion this year and to $15 billion in 2024, 2025, 2026 and 2027.
- 94% of Medicare beneficiaries say they would prefer to receive post-hospital, short-term care at home instead of in a nursing home.
- Home health saves the Medicare Trust Fund $1.38 billion (over six years) due to avoided hospitalizations and skilled nursing placement.
- Without access to home health, hospital lengths of stay are increasing and patients are not able to move easily from hospital to home.
“We applaud Senator Stabenow and Collins for their leadership in introducing the Preserving Access to Home Health Act of 2023 and their ongoing efforts to protect the Medicare home health benefit. This legislation offers the stability the Medicare home health community so urgently needs,” said Joanne Cunningham, CEO of the Partnership. “We strongly support this legislative solution and will work diligently with lawmakers in Congress to enlist broad support for this bill among lawmakers, provider stakeholders and the Medicare community.”