Click here to close now.




















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
Learn how to solve the problem of keeping files in sync between multiple Docker containers. In his session at 16th Cloud Expo, Aaron Brongersma, Senior Infrastructure Engineer at Modulus, discussed using rsync, GlusterFS, EBS and Bit Torrent Sync. He broke down the tools that are needed to help create a seamless user experience. In the end, can we have an environment where we can easily move Docker containers, servers, and volumes without impacting our applications? He shared his results so yo...
Palerra, the cloud security automation company, announced enhanced support for Amazon AWS, allowing IT security and DevOps teams to automate activity and configuration monitoring, anomaly detection, and orchestrated remediation, thereby meeting compliance mandates within complex infrastructure deployments. "Monitoring and threat detection for AWS is a non-trivial task. While Amazon's flexible environment facilitates successful DevOps implementations, it adds another layer, which can become a ...
With SaaS use rampant across organizations, how can IT departments track company data and maintain security? More and more departments are commissioning their own solutions and bypassing IT. A cloud environment is amorphous and powerful, allowing you to set up solutions for all of your user needs: document sharing and collaboration, mobile access, e-mail, even industry-specific applications. In his session at 16th Cloud Expo, Shawn Mills, President and a founder of Green House Data, discussed h...
The Software Defined Data Center (SDDC), which enables organizations to seamlessly run in a hybrid cloud model (public + private cloud), is here to stay. IDC estimates that the software-defined networking market will be valued at $3.7 billion by 2016. Security is a key component and benefit of the SDDC, and offers an opportunity to build security 'from the ground up' and weave it into the environment from day one. In his session at 16th Cloud Expo, Reuven Harrison, CTO and Co-Founder of Tufin,...
SYS-CON Events announced today that MobiDev, a software development company, will exhibit at the 17th International Cloud Expo®, which will take place November 3–5, 2015, at the Santa Clara Convention Center in Santa Clara, CA. MobiDev is a software development company with representative offices in Atlanta (US), Sheffield (UK) and Würzburg (Germany); and development centers in Ukraine. Since 2009 it has grown from a small group of passionate engineers and business managers to a full-scale mobi...
There are many considerations when moving applications from on-premise to cloud. It is critical to understand the benefits and also challenges of this migration. A successful migration will result in lower Total Cost of Ownership, yet offer the same or higher level of robustness. In his session at 15th Cloud Expo, Michael Meiner, an Engineering Director at Oracle, Corporation, analyzed a range of cloud offerings (IaaS, PaaS, SaaS) and discussed the benefits/challenges of migrating to each offe...
Chuck Piluso presented a study of cloud adoption trends and the power and flexibility of IBM Power and Pureflex cloud solutions. Prior to Secure Infrastructure and Services, Mr. Piluso founded North American Telecommunication Corporation, a facilities-based Competitive Local Exchange Carrier licensed by the Public Service Commission in 10 states, serving as the company's chairman and president from 1997 to 2000. Between 1990 and 1997, Mr. Piluso served as chairman & founder of International Te...
Mobile, social, Big Data, and cloud have fundamentally changed the way we live. “Anytime, anywhere” access to data and information is no longer a luxury; it’s a requirement, in both our personal and professional lives. For IT organizations, this means pressure has never been greater to deliver meaningful services to the business and customers.
In a recent research, analyst firm IDC found that the average cost of a critical application failure is $500,000 to $1 million per hour and the average total cost of unplanned application downtime is $1.25 billion to $2.5 billion per year for Fortune 1000 companies. In addition to the findings on the cost of the downtime, the research also highlighted best practices for development, testing, application support, infrastructure, and operations teams.
In their session at 17th Cloud Expo, Hal Schwartz, CEO of Secure Infrastructure & Services (SIAS), and Chuck Paolillo, CTO of Secure Infrastructure & Services (SIAS), provide a study of cloud adoption trends and the power and flexibility of IBM Power and Pureflex cloud solutions. In his role as CEO of Secure Infrastructure & Services (SIAS), Hal Schwartz provides leadership and direction for the company.
Puppet Labs has announced the next major update to its flagship product: Puppet Enterprise 2015.2. This release includes new features providing DevOps teams with clarity, simplicity and additional management capabilities, including an all-new user interface, an interactive graph for visualizing infrastructure code, a new unified agent and broader infrastructure support.
For IoT to grow as quickly as analyst firms’ project, a lot is going to fall on developers to quickly bring applications to market. But the lack of a standard development platform threatens to slow growth and make application development more time consuming and costly, much like we’ve seen in the mobile space. In his session at @ThingsExpo, Mike Weiner, Product Manager of the Omega DevCloud with KORE Telematics Inc., discussed the evolving requirements for developers as IoT matures and conducte...
Container technology is sending shock waves through the world of cloud computing. Heralded as the 'next big thing,' containers provide software owners a consistent way to package their software and dependencies while infrastructure operators benefit from a standard way to deploy and run them. Containers present new challenges for tracking usage due to their dynamic nature. They can also be deployed to bare metal, virtual machines and various cloud platforms. How do software owners track the usag...
Explosive growth in connected devices. Enormous amounts of data for collection and analysis. Critical use of data for split-second decision making and actionable information. All three are factors in making the Internet of Things a reality. Yet, any one factor would have an IT organization pondering its infrastructure strategy. How should your organization enhance its IT framework to enable an Internet of Things implementation? In his session at @ThingsExpo, James Kirkland, Red Hat's Chief Arch...
Providing the needed data for application development and testing is a huge headache for most organizations. The problems are often the same across companies - speed, quality, cost, and control. Provisioning data can take days or weeks, every time a refresh is required. Using dummy data leads to quality problems. Creating physical copies of large data sets and sending them to distributed teams of developers eats up expensive storage and bandwidth resources. And, all of these copies proliferating...