Home Health Providers Stumble on a Pot of Gold

McKnight’s Home Care | By Liza Berger
 
There is such a thing as serendipity — that unpredictable and uncontrollable turn of events that just happens to work in your favor. Home health got a little serendipity this week.
 
Just one day after a hearing held by a Senate healthcare subcommittee that by anyone’s critical assessment was a home run for the field, the industry held its annual fly-in. Talk about momentum — and ready-made conversation starters.
 
When home health providers visited their senators and representatives Wednesday, they could confidently reference the resounding support voiced by the senators for their cause. These elected officials stood against impending Medicare cuts and championed funding to alleviate the workforce shortage, thereby ensuring the continued viability of home care providers.
 
Providers may have recounted firsthand accounts from the hearing itself, including the testimony of Carrie Edwards, RN, director of home care services at Mary Lanning Healthcare in Hastings, NE. Her authentic narrative highlighted how her service area had dwindled from encompassing parts of 13 counties to just one.
 
They also undoubtedly relied on alarming statistics given by William Dombi, president of the National Association for Home Care & Hospice, concerning the decline of the home health benefit. Among these:
 
-In 2011, 3.5 million users of home health services received 36 visits per year. Ten years later, only 3 million people used the home health benefit.
 
-Since 2011, the number of home health agencies has dropped by over 1,000 nationwide.
 
-Home health spending is virtually the same as it was in 1997. Only $17 billion annually is spent on home health. That compares with skilled nursing facility spending, which totals $27.2 billion a year, and hospital spending, which is $130 billion a year.
 
In the face of this shortage, the hearing was advocacy gold for NAHC and the other home care organizations who came to the capital this week for the fly-in. Who could have foreseen such a fortuitous turn of events?
 
There’s a well-word adage: I’d rather be lucky than good. Today, looking at the near future, with the prospect of millions of dollars in Medicare cuts, I think home health providers might agree with this sentiment.

Lawmakers Back Home Health Providers, Condemn Payment Cuts In Symbolic Subcommittee Hearing

Home Health Care News | By Andrew Donlan
 
The Senate Finance Committee’s Subcommittee on Health Care held a hearing Thursday regarding aging in place and access to home health care in the U.S.

While current struggles were highlighted throughout, the hearing was ultimately a symbolic win for home health providers across the country.

Lawmakers came across as more educated on home health care – and the issues the sector faces – than ever. They also, generally, seemed to be unsure why more investment wasn’t being put toward home-based care.

“Because of the lack of a coordinated policy, seniors often end up in a more costly environment, in a less desirable environment, and – I would suggest – a more dangerous environment for their long-term health,” Sen. Ben Cardin (D-MA), the chair of the subcommittee, said.

Cardin also began the hearing by mentioning there’s a “great deal of interest” from both Democrats and Republicans on the topic of home health care.

The hearing was “very well attended,” according to Partnership for Quality Home Healthcare CEO Joanne Cunningham. 

The chair of the Senate Finance Committee, Ron Wyden, was also there, for instance.

Witnesses for the hearing included: William A. Dombi, the president of the National Association for Home Care & Hospice; Carrie Edwards, the director of home care services at Mary Lanning Healthcare; Judith Stein, the executive director of the Center for Medicare Advocacy; and David Grabowski, a professor and researcher at Harvard Medical School.

“I think the big message was very clearly that the Senate Finance Committee, on a bipartisan basis, cares a lot about the Medicare home health program, and is concerned about reimbursement cuts and the impact that workforce shortages are having on access to care,” Cunningham told Home Health Care News.

The overarching theme was, of course, the Centers for Medicare & Medicaid Services’ (CMS) home health payment cuts.

Witnesses were able to openly discuss the impact that cuts have had up to this point, and the impact further cuts would have in the future.

They were also able to discuss the dangers of skyrocketing referral rejection rates, the impact of further Medicare Advantage (MA) penetration and the issues the provider community takes with Medicare Payment Advisory Commission’s (MedPAC) reports on home health care.

“It is overall financial margins that really measure financial stability, not the incomplete analysis presented by MedPAC,” Dombi said during the hearing. “Medicare margins – to the extent they exist – are subsidizing other payers like Medicaid and Medicare Advantage.”

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