Home Health & Hospice Week

Highest profit margin in nearly a decade may contribute to cut recommendation.

The Medicare Payment Advisory Commission bases its home health cut recommendation on these pre-PDGM, pre-COVID data points this year. Will lawmakers do the same?

• The number of home health agencies declined 1.7 percent from 2018 to 2019 to 11,356. The number has declined every year since 2013.
• Medicare home health payments decreased 0.5 percent from 2018 to 2019 to $17.8 billion. That’s down from $18.3 billion in 2011.
• Home health users fell 2.4 percent from 2018 to 2019 to 3.3 million. That’s down from 4.4 million in 2011.
• Home health episodes declined 3 percent from 2018 to 2019 to 6.1 million. That’s down from 6.8 million episodes in 2011.
• The share of beneficiaries using home health decreased 1.1 percent from 2018 to 2019 to 8.6 percent. That’s down from 9.4 percent in 2011.
• Visits per episode declined very slightly from 17.8 visits in 2018 to 17.7 visits in 2019. Skilled nursing visits were down 1.2 percent and aide visits were down 7.1 percent in that time period.
• HHA’s average Medicare profit margin of 15.8 percent in 2019 is up from 15.3 percent in 2018. Those compare to average margins of 15.2 percent in 2017, 15.5 percent in 2016, 15.6 percent in 2015, 10.8 percent in 2014, 12.7 percent in 2013, 14.4 percent in 2012, and 14.8 percent in 2011.