Home Health & Hospice Week

Profit margin jumps 44% in single year.

Indicators including the number of home health agencies, the number of visits, and the average number of episodes per user all fell in 2015, but the Medicare Payment Advisory Commission still thinks agencies are substantially overpaid by Medicare.

Take a look at the 2015 HHA data MedPAC cites in its annual report to Congress:

• The number of home health agencies fell nearly 1 percent from 2014 to 12,346.
• The number of home health visits fell very slightly to 115.1 million.
• The average number of visits per user fell by one visit to 33.
• The average number of episodes per user fell 0.6 percent.
• The number of episodes overall increased 0.3 percent to about 17,000 episodes, reversing a three year decline.
• The number of home health users increased 1 percent to 3.5 million.
• Medicare home health spending grew 2.3 percent to $18.1 billion.
• Medicare profit margins for freestanding HHAs averaged 15.6 percent, a startling 44 percent increase over the 2014 margin figure of 10.8 percent.
• The percent of fee-for-service users who used home care grew by 1 percent to 9.1 percent.
• Rebasing required by the Affordable Care Act has cut payments per episode by 3 percent from 2014 to 2017.
• The share of episodes with six or more therapy visits increased between 2008 and 2015 from 37 percent to 46 percent.
• The number of episodes not preceded by a hospital or post-acute care stay has fallen 6.5 percent since 2011, but in the 10 years before that had increased 127 percent. Likewise, the number of episodes with a preceding stay grew 1 percent from 2011 to 2015, but had grown only 14.8 percent in the previous decade.
• If the Centers for Medicare & Medicaid Services eliminates therapy from the prospective payment system case mix methodology, MedPAC estimates that nonprofit HHAs’ payments would increase by 4.8 percent; for-profit agencies’ payments would decrease by 2.1 percent; facility-based agencies’ payments would rise by 3.9 percent; and freestanding HHAs’ payments would fall by 0.8 percent.