Home Health & Hospice Week

Will the 2 percent cut be based on start dates or end dates for episodes?

Lawmakers failed to head off the sequester before its March 1 implementation date, but you still have a little breathing room on the 2 percent across-the-board cuts slated to impact Medicare payment rates.

Although the bulk of the government’s cuts took place on March 1, the 2 percent Medicare reductions won’t hit until April 1. The delay is giving many health care providers hope that once the impact of the other sequestration cuts are felt by the rest of the government programs in March, Congress will be quick to fix the problem before the Medicare cuts take effect.

Flashback: The sequester was supposed to impact your payments at the beginning of 2013, but the Middle Class Tax Relief Act was passed on Jan. 1, delaying the sequester for two months. Many providers expected Congress to take that time to find ways to avert the cuts, which did not happen.

How the cuts will specifically affect home care providers is anyone’s guess, but experts are making predictions. Home health agencies are likely to see the cut based on the date an episode ends rather than begins, predicts the National Association for Home Care & Hospice.

Hospices will likely see cuts based on days of care, NAHC forecasts. Since Medicare now requires hospices to bill on a calendar month basis, April claims would be affected.

If Congress does try to pass legislation averting the sequestration cuts, home care providers could end up in a worse place than before, experts warn. Law- and policy makers continue to cite the home care industry’s high profit margins and the hospice industry’s explosive growth as reasons to rein in spending in the benefits.

Medicare spending on home care and hospice were preserved in the legislation that delayed the sequester until March 1, pointed out the Visiting Nurse Associations of America at the time. But "having escaped cuts in the short-term deal, home health cuts may again be at the front line when negotiations for long-term fixes are considered," VNAA warned.

Home care providers must stress the "No Cuts, No Copays" message to their representatives, NAHC urges. "A growing number of lawmakers that are eager to overhaul Medicare in ways that would be detrimental to the home health community," the trade group warns in its member newsletter. Powerful lawmakers are "in favor of additional copays and cost sharing measures" for home care.