Welcome!

News Feed Item

Home Health Leaders Express Disappointment in MedPAC Report to Congress

MedPAC recommendations would exacerbate the risk already faced by the Medicare program's most vulnerable patient population and the quality providers on whom they depend

WASHINGTON, March 20, 2014 /PRNewswire-USNewswire/ -- Home health leaders today expressed disappointment with the Medicare Payment Advisory Commission's (MedPAC) March 2014 Report to Congress, which calls for further reductions to Medicare home health funding.  The home health community has pointed to key methodological issues that warrant close attention and expressed concern that further cuts to the Medicare home health benefit will place vulnerable seniors, women, and jobs at even greater risk than is already being experienced due to deep cuts now in effect.

On January 1, the Centers for Medicare and Medicaid Services (CMS) began imposing a Medicare home health rebasing cut of 14 percent over the next four years – the maximum allowable under the Affordable Care Act (ACA).  This cut is considered severe, since CMS itself conceded in the Home Health Prospective Payment System (HHPPS) Final Rule that "approximately 40 percent" of all home health providers will suffer negative margins as a result of the substantial losses imposed by this cut.

In light of methodological concerns raised by the home health community, the Partnership is undertaking an analysis that seeks to be responsive to those concerns by incorporating the following:

  • Margins analysis that tracks with CMS' admission that "approximately 40 percent" of all HHAs will experience negative margins as a result of the ACA rebasing adjustment;
  • Margins analysis that tracks with Avalere Health's analysis of Securities and Exchange Commission (SEC) filings, which found that the largest home health providers experienced an average net margin of just 2.8 percent in 2012;
  • The estimated $72.5 billion in Medicare cuts already in place under current law (2011-2020) and the estimated additional $21.5 billion in cuts that are being imposed by CMS' ACA rebasing adjustment of -3.5% per year between 2014 and 2017;
  • The impact of the ACA's productivity adjustment rate cut, which is slated to go into effect on January 1, 2015 and is estimated to reduce Medicare home health funding by an additional $8-10 billion over 10 years;
  • An assessment of the ability of home health agencies (HHAs) to adjust to cuts by reducing visits (Medicare data indicates that the level of care in standard episodes is virtually unchanged);
  • A broader data set than the limited cost report audits, which CMS itself did not use because the sample size of only 98 home health agencies (HHAs) represents less than 1 percent of all HHAs;
  • The application of market basket increases to offset market basket costs, rather than a portion of the ACA rebasing cut (which would cause HHAs to bear increased market basket costs without any offsetting adjustment); and,
  • A recognition that CMS applied the maximum rebasing cut allowable in the HHPPS Final Rule, which imposed an annual rebasing cut of 3.5 percent of the 2010 Medicare home health standardized payment rate, which was the maximum allowable cut under the ACA.   

"Due to the vital role that MedPAC plays in the development of Medicare policy, patients, advocates and providers across the home health community are hopeful that future recommendations will benefit from a complete analysis of key factors," stated Eric Berger, CEO of the Partnership for Quality Home Healthcare.   "By Medicare's own admission, the 14 percent cut in the HHPPS Final Rule will drive 40 percent of providers to net losses, therefore jeopardizing Medicare's most vulnerable patients, devoted clinicians and thousands of small businesses.  As a result, comprehensive data analyses are more important now than ever."

The Partnership further expressed concern that any additional cuts to Medicare payments or the re-imposition of a beneficiary copayment, as recommended by MedPAC, would put Medicare's most vulnerable patient population at risk.  As shown below, new data released this month show home health beneficiaries are older, sicker, poorer, are more likely to be female, are more likely to be members of ethnic or racial minority populations and have greater functional limitations, disabling conditions, and greater difficulty completing routine tasks than all other beneficiaries in the Medicare program.

 

Avalere Home Health Beneficiary Study:  Key Findings

Medicare

Home Health Beneficiaries

All Other

Medicare Beneficiaries

Women

60.07%

53.9%

Beneficiaries aged 85+

24.4%

12.1%

Beneficiaries with 4+ chronic conditions

74.7%

48.5%

Beneficiaries needing assistance with 2+ Activities of Daily Living (ADLs)

23.5%

7.6%

Beneficiaries at or below 200% of Federal Poverty Level (FPL)

66.2%

47.9%

Beneficiaries from ethnic or racial minority population

19.3%

14.9%

Dual-eligible Medicare-Medicaid beneficiaries

26.7%

17.7%

"The Administration's rebasing regulation disproportionately impacts the most vulnerable Medicare beneficiaries and women by sharply cutting funding for the care of the predominantly female home health beneficiary population, by placing further burdens on their predominantly female family caregivers and by placing at risk the jobs of predominantly female nurses and therapists," added Berger. 

"The Partnership strongly opposes additional cuts to home health or increased patient costs, and instead supports targeted, pro-patient program integrity initiatives and reforms that emphasis quality care and efficiencies within the delivery system," Berger concluded.  "Instead of further across-the-board cuts that put vulnerable seniors' and women's healthcare and jobs in jeopardy, the Partnership is urging the adoption of targeted reforms that will improve quality, efficiency and patient choice."

The Medicare home health benefit currently provides clinically advanced, cost-effective and patient preferred healthcare to 3.5 million American seniors and disabled individuals.

The Partnership for Quality Home Healthcare was established to assist government officials in ensuring access to skilled home healthcare services for seniors and disabled Americans. Representing community- and hospital-based home healthcare agencies across the United States, the Partnership is dedicated to developing innovative reforms to improve the quality, efficiency and integrity of home healthcare. To learn more, visit www.homehealth4america.org. To join the home healthcare policy conversation, connect with us on Facebook, Twitter and our blog

SOURCE Partnership for Quality Home Healthcare

More Stories By PR Newswire

Copyright © 2007 PR Newswire. All rights reserved. Republication or redistribution of PRNewswire content is expressly prohibited without the prior written consent of PRNewswire. PRNewswire shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon.

Latest Stories
Five years ago development was seen as a dead-end career, now it’s anything but – with an explosion in mobile and IoT initiatives increasing the demand for skilled engineers. But apart from having a ready supply of great coders, what constitutes true ‘DevOps Royalty’? It’ll be the ability to craft resilient architectures, supportability, security everywhere across the software lifecycle. In his keynote at @DevOpsSummit at 20th Cloud Expo, Jeffrey Scheaffer, GM and SVP, Continuous Delivery Busine...
With major technology companies and startups seriously embracing IoT strategies, now is the perfect time to attend @ThingsExpo 2016 in New York. Learn what is going on, contribute to the discussions, and ensure that your enterprise is as "IoT-Ready" as it can be! Internet of @ThingsExpo, taking place June 6-8, 2017, at the Javits Center in New York City, New York, is co-located with 20th Cloud Expo and will feature technical sessions from a rock star conference faculty and the leading industry p...
SYS-CON Events announced today that Progress, a global leader in application development, has been named “Bronze Sponsor” of SYS-CON's 20th International Cloud Expo®, which will take place on June 6-8, 2017, at the Javits Center in New York City, NY. Enterprises today are rapidly adopting the cloud, while continuing to retain business-critical/sensitive data inside the firewall. This is creating two separate data silos – one inside the firewall and the other outside the firewall. Cloud ISVs oft...
SYS-CON Events announced today that Juniper Networks (NYSE: JNPR), an industry leader in automated, scalable and secure networks, will exhibit at SYS-CON's 20th International Cloud Expo®, which will take place on June 6-8, 2017, at the Javits Center in New York City, NY. Juniper Networks challenges the status quo with products, solutions and services that transform the economics of networking. The company co-innovates with customers and partners to deliver automated, scalable and secure network...
In recent years, containers have taken the world by storm. Companies of all sizes and industries have realized the massive benefits of containers, such as unprecedented mobility, higher hardware utilization, and increased flexibility and agility; however, many containers today are non-persistent. Containers without persistence miss out on many benefits, and in many cases simply pass the responsibility of persistence onto other infrastructure, adding additional complexity.
SYS-CON Events announced today that CA Technologies has been named "Platinum Sponsor" of SYS-CON's 20th International Cloud Expo®, which will take place on June 6-8, 2017, at the Javits Center in New York City, New York, and 21st International Cloud Expo, which will take place in November in Silicon Valley, California.
New competitors, disruptive technologies, and growing expectations are pushing every business to both adopt and deliver new digital services. This ‘Digital Transformation’ demands rapid delivery and continuous iteration of new competitive services via multiple channels, which in turn demands new service delivery techniques – including DevOps. In this power panel at @DevOpsSummit 20th Cloud Expo, moderated by DevOps Conference Co-Chair Andi Mann, panelists will examine how DevOps helps to meet th...
DevOps is being widely accepted (if not fully adopted) as essential in enterprise IT. But as Enterprise DevOps gains maturity, expands scope, and increases velocity, the need for data-driven decisions across teams becomes more acute. DevOps teams in any modern business must wrangle the ‘digital exhaust’ from the delivery toolchain, "pervasive" and "cognitive" computing, APIs and services, mobile devices and applications, the Internet of Things, and now even blockchain.
Did you know that you can develop for mainframes in Java? Or that the testing and deployment can be automated across mobile to mainframe? In his session at @DevOpsSummit at 20th Cloud Expo, Vaughn Marshall, Sr. Principal Product Owner at CA Technologies, will discuss and demo how increasingly teams are developing with agile methodologies using modern development environments and automating testing and deployments, mobile to mainframe.
SYS-CON Events announced today that Hitachi, the leading provider the Internet of Things and Digital Transformation, will exhibit at SYS-CON's 20th International Cloud Expo®, which will take place on June 6-8, 2017, at the Javits Center in New York City, NY. Hitachi Data Systems, a wholly owned subsidiary of Hitachi, Ltd., offers an integrated portfolio of services and solutions that enable digital transformation through enhanced data management, governance, mobility and analytics. We help globa...
@DevOpsSummit has been named the ‘Top DevOps Influencer' by iTrend. iTred processes millions of conversations, tweets, interactions, news articles, press releases, blog posts - and extract meaning form them and analyzes mobile and desktop software platforms used to communicate, various metadata (such as geo location), and automation tools. In overall placement, @DevOpsSummit ranked as the number one ‘DevOps Influencer' followed by @CloudExpo at third, and @MicroservicesE at 24th.
@GonzalezCarmen has been ranked the Number One Influencer and @ThingsExpo has been named the Number One Brand in the “M2M 2016: Top 100 Influencers and Brands” by Analytic. Onalytica analyzed tweets over the last 6 months mentioning the keywords M2M OR “Machine to Machine.” They then identified the top 100 most influential brands and individuals leading the discussion on Twitter.
SYS-CON Events announced today that Hitachi, the leading provider the Internet of Things and Digital Transformation, will exhibit at SYS-CON's 20th International Cloud Expo®, which will take place on June 6-8, 2017, at the Javits Center in New York City, NY. Hitachi Data Systems, a wholly owned subsidiary of Hitachi, Ltd., offers an integrated portfolio of services and solutions that enable digital transformation through enhanced data management, governance, mobility and analytics. We help globa...
Blockchain is a shared, secure record of exchange that establishes trust, accountability and transparency across supply chain networks. Supported by the Linux Foundation's open source, open-standards based Hyperledger Project, Blockchain has the potential to improve regulatory compliance, reduce cost and time for product recall as well as advance trade. Are you curious about Blockchain and how it can provide you with new opportunities for innovation and growth? In her session at 20th Cloud Exp...
In his keynote at 19th Cloud Expo, Sheng Liang, co-founder and CEO of Rancher Labs, discussed the technological advances and new business opportunities created by the rapid adoption of containers. With the success of Amazon Web Services (AWS) and various open source technologies used to build private clouds, cloud computing has become an essential component of IT strategy. However, users continue to face challenges in implementing clouds, as older technologies evolve and newer ones like Docker c...