Home Health & Hospice Week

Watch out: Boosted survey funding would translate to more surveys.

The Biden administration has blown the whistle to start the 2024 budget negotiation season with a $6.8 trillion budget proposal, and there are some positives for home care providers.

On March 9, the president released the proposal which “details a blueprint” to achieve a number of objectives, including “protect[ing] and strengthen[ing] Medicare,” the Department of Health and Human Services says in a release.

Take a look at the budget proposal provisions that will most affect home care providers:

• HCBS. “The FY 2024 budget affords $150 billion over 10 years in improving and strengthening Medicaid home and community-based services to ensure more people who are aging and those with disabilities can receive care in their home or community,” HHS says. “As America’s older population increases, it is critical to promote the health, safety, and dignity of elders through long term care,” HHS adds.

Both President Biden and HHS Secretary Xavier Becerra have mentioned the value of home care in recent speeches. On March 9, the president once again referenced home care in remarks on the budget proposal.

“It’s cheaper if we … provide for the ability for [seniors] to stay in their homes,” President Biden said in Philadelphia. “It’s not only a right thing to do, but it’s cheaper on the taxpayer.”

Home care providers and their representatives are glad to see the proposal. The Home Care Association of America “is grateful to have a president who continues to recognize the value of home care,” HCAOA CEO Vicki Hoak says in a release. “This budget demonstrates the commitment to ensure all Americans have the opportunity to age in their own homes, living as independently as possible.”

• Healthcare workforce. The budget “provides $2.7 billion for [Health Resources and Services Administration] workforce programs, including $947 million in mandatory resources, to expand workforce capacity across the country,” HHS says. “The discretionary budget includes $28 million for a new program to address growing concerns related to healthcare workforce shortages,” the agency says in the release.

“There are more than 53 million caregivers in the United States, and together they provide for the $470 billion in unpaid care each year,” Secretary Becerra noted in a budget press conference. “This budget gives them the support they deserve AND funds the recruitment of 1.3 million additional homecare workers needed to meet the demand,” he said.

“As the demand for healthcare workers increases, HHS remains committed to strengthening and expanding the workforce,” the agency says.

• HCFAC. A “new investment in Health Care Fraud and Abuse Control will save taxpayers $5 billion over the next 10 years,” Becerra highlighted in the press conference. (See more HCFAC budget details in related story, this page.)
• Surveys. The budget includes “$566 million for the discretionary CMS Survey and Certification Program, nearly a 40 percent increase above enacted funding, for nursing homes and other facilities’ health and safety inspection surveys,” HHS says in its 169-page Budget in Brief document that summarizes the Biden budget. While the release mentions nursing homes, home health and hospice agencies would likely see more survey activity as well, observers expect.
• Drug costs. HHA patients may see lower drug costs because the budget “helps make prescription drugs more affordable for seniors by limiting Medicare cost-sharing on high value generic drugs to $2” and “limits cost-sharing for insulin at $35 a month,” among other drug provisions, HHS notes in the release.

In its release, HHS also pats itself on the back for initiatives it casts as positive for the budget, including making the Home Health Value-Based Purchasing program permanent in 2022 and including hospice in the Medicare Advantage Value-Based Insurance Design model.

Note: The HHS Budget in Brief is at www.hhs.gov/sites/ default/files/fy-2024-budget-in-brief.pdf.