Congressional Action Urgently Needed to Preserve Seniors’ Access to Home Health
In June, the Centers for Medicare & Medicaid Services (CMS) announced plans to cut Medicare’s home health benefit by an estimated $18 billion over the next decade – cuts that far exceed anything this community has previously experienced. What is most troubling about these proposed cuts is that they seem to disregard the following facts: the demand for receiving care in the home is increasing, home health reduces overall Medicare spending, and healthcare delivery costs are mounting across-the-board.
Fortunately, bipartisan lawmakers in the House and Senate are taking steps to preserve access to vital, patient-preferred home health services by introducing legislation to block these severe cuts from going into effect in 2023, as proposed by CMS.
Since the Medicare home health benefit was created, it has given hope to patients because they no longer have to be admitted to institutional settings to receive rehabilitation, recovery, and stabilization care. Not only does home health improve seniors’ quality of life, but it also reduces costly hospitalizations and readmissions, generating billions of dollars in savings for taxpayers.
Unfortunately, the federal government is woefully out of sync with seniors’ desires,
despite the many benefits of aging in the comfort of home. CMS’s devastating new proposal threatens to curtail seniors’ access to the home health services that allow them to heal close to their loved ones.
If finalized as proposed, the Home Health Prospective Payment System (“HHPPS”) Proposed Rule for Calendar Year (CY) 2023 would pull the rug out from under home health providers during a time of unparalleled stress. The proposed rule would severely disrupt America’s home health system by leveraging a permanent 7.69% payment cut on Medicare home health, eliminating $1.33 million from the system in 2023 alone. Further, Medicare is planning to “clawback” an additional $2 billion from home health providers for care they previously delivered in 2020 and 2021 – in response to a deadly pandemic.
Worse yet, these cuts are unjustified. This year, baseline spending for the Medicare home health program was a full $1 billion less than overall home health spending in 2019, undercutting Medicare’s justification for the cut.
The colossal cut comes on top of soaring inflation, rapidly rising labor costs, record high gas prices, pandemic-related disruptions, and the annual continuation of a flawed behavioral assumption adjustment. At the same time, there is a surging demand for home health services—referrals for home health services have increased 33% since 2019. Taken together, these challenges represent the most serious threat to this sector in decades. What’s worse, the cuts could undermine the delivery of high-quality home healthcare services to millions of American seniors if home health agencies in rural and underserved regions are forced to close.
Congress has long recognized the importance of stabilizing the nation’s home health system. In 2018, Congress made clear its intention to avoid cuts to home health when it legislated budget-neutral home health reforms. Specifically, Congress directed CMS to implement a new payment system without reducing the overall amount Medicare would otherwise pay for those services. So why is CMS now using that same language to make an unauthorized reduction to the base payment rate for Medicare home health payments?
It’s no surprise that older Americans want to receive their care at home. Instead of moving into an unfamiliar environment, such as a nursing home or other institutional setting, an overwhelming majority of older Americans want to receive care in the safe, comfortable, and convenient environment they know best—their home.
The Preserving Access to Home Health Act of 2022 (S. 4605/H.R. 8581) – sponsored by Senators Debbie Stabenow (D-MI) and Susan Collins (R-ME) and Representatives Terri Sewell (D-AL) and Vern Buchanan (R-FL) – will prevent the implementation of the 7.69% permanent cut and additional $2 billion in “clawback” cuts in 2023. This bipartisan legislation is urgently needed to stabilize this vital sector and ensure patients have continued access to home health.
We have both experienced the many benefits and comforts of seeing loved ones age at home with the help of skilled and compassionate home health professionals. It is an essential senior benefit that must be protected.
We urge our former colleagues in Congress to act now to pass the Preserving Access to Home Health Act.
Blanche L. Lincoln is a former U.S. Congresswoman and U.S. Senator from Arkansas. Joseph Crowley is a former U.S. Congressman and Chair of the House Democratic Caucus from New York.
