Home Health & Hospice Week

Evidence that home care providers will face tough budget times under Medicare next year continues to mount.

Medicare beneficiaries are seeing little to no problems accessing home care services, the Medicare Payment Advisory Commission maintains. About 97 percent of beneficiaries live in a zip code served by two HHAs, and 99 percent of benes have one agency in their zip code, MedPAC staffer Sharon Cheng said in the advisory body's Nov. 16 meeting.

The combination of a growing provider base (see story, p. 331), no access problems and high profit margins for the industry is a recipe for home health spending cuts, predicts Bob Wardwell with the Visiting Nurse Associations of America. Throwing fraud and abuse suspicions about outliers or other issues into the mix will only strengthen the motivation for cuts.

MedPAC is likely to make a recommendation unfavorable to the home care industry - and lawmakers are equally likely to take the commission up on its advice, Wardwell expects.

Legislators will be aggressively looking for places to trim the fat. "Deficit spending running at over $400 billion annually will crowd out new initiatives and put pressure on existing programs," notes the American Association for Homecare. "Medicare and Medicaid in particular are potential targets."

HHAs shouldn't expect any renewal of the rural add-on set to expire April 1, expects consultant Tom Boyd with Rohnert Park, CA-based Boyd & Nicholas. And agencies can all but kiss their inflation update for 2006 good-bye - if they don't see worse cuts, say experts.