Home Health & Hospice Week

Louisiana racks up highest HH utilization rate, according to new report.

Although it seems like nothing can stop the rise of Medicare Advantage plans, a watchdog agency recommen­dation might have some effect.

In its annual June report to Congress, the Medicare Payment Advisory Commission notes one big problem with MA plans — and it’s not the same thing that generally bothers home health agencies about them. HHAs complain that MA plans restrict coverage and utilization, underpay for services, and complicate billing.

MedPAC, however, notes that “no iteration of private plan contracting has yielded net aggregate savings for Medicare,” according to a release about the report. The influential advisory body to Congress recommends lawmakers implement a new MA benchmarking system that will “achieve savings for the program.”

The report also examines rural beneficiaries’ access to care, noting that “for home health and skilled nursing facility services, we found that rural beneficiaries had similar or higher utilization rates in 2018 than urban beneficiaries.” Furthermore, “service use varied substantially across the nation’s geographic regions. Variation in home health use was particularly notable, with utilization rates varying by sixfold to eightfold across regions,” the report tells lawmakers.

Specifically: “Home health use was high in both rural and urban areas of the Gulf states but lower in other parts of the country,” the report says. “For example, in Louisiana, home health use was 147 percent above the national average among rural beneficiaries and 60 percent above the national average among urban beneficiaries. In contrast, home health use was 75 percent below the national average among both rural and urban beneficiaries in Hawaii.”

MedPAC also examines private equity involvement in Medicare, including Humana’s Kindred at Home acquisition, and alternative payment models in the report available via a link at http://medpac.gov/-documents-/reports.