Home Health & Hospice Week

More travel time means more difficulty recruiting and retaining staff.

“The nation is experiencing a well-documented increase in gas prices,” notes Amedisys Inc. CEO Chris Gerard in the national chain’s comment letter. “Home health is uniquely impacted by this increase, as our providers spend significant quantities of time on the road to meet the needs of Medicare beneficiaries. Particularly in rural areas, the impact of higher gas prices is profound,” Gerard emphasizes.

Stats: “In 2021, Amedisys employees drove approximately 114 million miles” in both fleet and personal vehicles, Gerard reports. So far in 2022, “Amedisys has spent approximately $3.1 million on our various mileage reimbursement supplemental programs to offset our employees’ increased fuel costs. We have also implemented a mid-year increase to our standard mileage reimbursement rate effective July 1, 2022, similar to the IRS, with an estimated cost of approximately $800,000 for the remainder of 2022 and projected at a full year cost of $1 million in 2023,” he adds. “We estimate that our fleet vehicles alone have seen an increase in fuel prices of $1.9 million for the past twelve months, with approximately $600,000 directly attributable to home health clinician usage,” according to the letter.

“Serving rural communities adds significant cost to VNH with the transportation and mileage expense,” notes Visiting Nurse and Hospice for Vermont and New Hampshire CEO Johanna Beliveau in the agency’s comment letter.

“Rural agencies have … been especially hard hit by increases in gas prices over the past year,” emphasizes Martha Leclerc with Sanford Health system in the system’s comment letter. “Because our home health agencies service hundreds of miles of rural areas, the cost of gas has had a significant negative impact on the viability of our agencies. In fact, we have closed three home health agencies over the past year and consolidated several more,” Leclerc reports.

The proposed cuts “will make our rural agencies financially unsustainable and will lead to additional closures,” Leclerc warns. “We do not want to contribute to the lack of access in rural America, but a cut of the size proposed by CMS will leave us no choice but to continue to reduce services,” she predicts.

“Closure of home health agencies in our rural service areas has increased the number of miles per visit by 42 percent since 2019,” says Dianne Hansen, CEO of Partners In Home Care Inc. in Missoula, Montana, in the company’s letter. “The rise in fuel costs along with the commitment of our agency to serve the rural communities in our service areas has increased our mileage costs by 27 percent from 2021 to 2022,” she adds.

“Without adequate reimbursement, our agency cannot continue to provide safe, quality care to home health beneficiaries. There are few places to cut expenses,” Hansen tells CMS. “It would be regrettable if our agency was forced to curtail services in rural areas due to reimbursement cuts.”