Home Health & Hospice Week

Spending, number of HHAs, users, and periods of care all down in latest period.

Policy- and lawmakers use critical data provided by the Medicare Payment Advisory Commission to make tough budget decisions. Take a look at the 2021 home health stats MedPAC provides in its latest annual report to Congress:

• The Medicare profit margin for freestanding home health agencies in 2021, the latest year available, is an eye-popping 24.9 percent. That compares to a margin of 20.2 percent in 2020, 15.8 percent in 2019, 15.3 percent in 2018, 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 2021, and 14.8 percent in 2011.
• For-profit HHAs averaged a 26.1 percent margin while nonprofits averaged a 20.2 percent margin.
• HHAs’ Medicare profit margin will be 17.0 percent in 2023, although that figure may creep up if inflation slows, MedPAC cautions.
• Medicare spent $16.9 billion on home health care services, down 1.2 percent from 2020 and down more than 10 percent from 2013.
• The number of HHAs fell 0.8 percent to 11,474. That puts the number of HHAs per 10,000 beneficiaries at 1.8, down 25 percent from 2.4 in 2013.
• There were 3.0 million home health fee-for-service Medicare users, down 1.1 percent from 2020 and more than 11 percent since 2017.
• The number of 30-day periods of care fell 2.9 percent from 2020. “However, the number of beneficiaries enrolled in FFS also declined as more beneficiaries enrolled in Medicare Advantage,” MedPAC notes. “As a result, the number of 30-day periods per 100 FFS beneficiaries increased by almost 1 percent in 2021, and the share of FFS beneficiaries using home health care increased to 8.3 percent.”
• The average number of in-person visits per 30-day period declined by 4.7 percent, probably in part due to telehealth visit increases. Relatedly, costs per 30-day period fell by 2.9 percent.
• HHAs made 76.8 million home health visits in 2021, down 5.3 percent from 2020 and down 26.7 percent from 2017. The number of in-person visits declined for every discipline except physical therapy in 2021.
• “Per capita use of the benefit increased 2.5 percent in 2021,” MedPAC notes. “In addition, the number of 30-day periods per Medicare FFS beneficiary also increased [0.7 percent]. Thus, despite the 2021 decline in aggregate use, the higher rate of home health users in 2021 indicates that HHAs are serving a rising share of the Medicare FFS population,” the report maintains.

Source: www.medpac.gov/wp-content/uploads/2023/03/Ch8_Mar23_MedPAC_Report_To_Congress_SEC.pdf.