Home Health & Hospice Week

Record numbers of home health agencies, visits and episodes are all drawing a big target on home health agencies' backs.

Here are the stats the Medicare Payment Advisory Commission is using when making its influential recommendations to Congress about your Medicare payments:

• Medicare spent $19 billion on HHA services in 2010.
• The number of agencies reached 11,600 in 2010. That's a 50 percent increase from 2002. "That exceeds the peak level of supply reached in the 1990s when Congress significantly changed the benefit to address fraud and problematic payment incentives," MedPAC staffer Evan Christman noted in the commission's December meeting. There were 650 new agencies -- 831 HHAs entered the program and 181 left it. That's down from 2009, when 1,000 new agencies opened.
• Nearly 10 percent of Medicare fee for service users -- 3.4 million -- were using home health in 2010. That's up from 2.5 million, or 7.2 percent, in 2002.
• The number of episodes increased 6.6 percent from 2002 to 2010, from 4.1 million to 6.8 million.
• Episodes per user have increased from 1.6 to 2.0 from 2002 to 2010. But that's actually downslightly from 2009.
• Freestanding HHAs' profit margin averages 19.4 percent. MedPAC is concerned that figure is "excessive," Christman noted. Hospital-based agencies averaged a -4.7 percent profit margin.
• MedPAC predicts agencies' average profit margin will fall to 13.7 percent in 2012.