Home Health & Hospice Week

Law- and policymakers likely soon will decide how to reconfigure the home health prospective payment system in light of alleged abuses of therapy utilization. Take a look at the statistics they will use to inform the decision.

The Senate Finance Committee uncovered these figures when investigating publicly traded home health companies' alleged improprieties regarding therapy utilization:

• At Baton Rouge, La.-based Amedisys Inc., the percent of the company's therapy episodes with 10 visits went from 9.1 percent in 2007 to 4.9 percent in 2008, the report says. "Also from 2007 to 2008, the number of therapy episodes receiving 6 visits increased from 4.6 percent to 5.3 percent, and the number of therapy episodes receiving 14 visits increased from 4.7 percent to 5.8 percent."

Amedisys' home health episodes with therapy reimbursement accounted for 71 percent of Medicare revenue in 2009, and 88 percent of its revenues came from Medicare.

• At Atlanta-based Gentiva Health Services Inc., the percent of the chain's therapy episodes with 10 visits decreased from 7.7 in 2007 to 5.8 percent in 2008, Senate investigators found. While there was a slight dip in therapy episodes with six visits, "the percentage of therapy utilization in  the 6-visit through 9-visit range increased, from 18.9 percent in 2007 to 22.1 percent in 2008," the report says. "The number of therapy episodes receiving 14 visits increased from 4.0 percent to 4.8 percent. And the number of therapy episodes receiving 20 visits increased from 1.6 percent to 2.1 percent."

Gentiva's home health episodes with therapy reimbursement accounted for 78 percent of Medicare revenue in 2009, and 82 percent of its revenues came from Medicare.

• Lafayette, La.-based LHC Group Inc. saw the biggest drop-off in 10-therapy-visit episodes, down from 20 percent in 2007 to 6.9 percent in 2008, the report says. "From 2007 to 2008 the number of therapy episodes receiving six visits increased from 2.5 percent to 5.5 percent," the report adds. "The number of therapy episodes receiving 14 visits increased from 4.6 percent to 8 percent. And the number of therapy visits receiving 20 visits increased from 0.7 percent to 2.1 percent."

LHC's home health episodes with therapy reimbursement accounted for 50 percent of Medicare revenue in 2009, and 81.7 percent of its revenues came from Medicare.

• At Louisville, Ky.-based Almost Family Inc., the percent of the chain's therapy episodes with 10 visits decreased from 9.4 in 2007 to 5.2 percent the next year, Senate staff found. "From 2007 to 2008, the number of therapy episodes receiving 6 visits increased from 4.5 percent to 6 percent, and the number of therapy episodes receiving 14 visits increased from 4.6 percent to 6.1 percent," the Senate Finance report says.

Almost Family's home health episodes with therapy reimbursement accounted for 75 percent of its revenues in 2009, and 77 percent of its revenues came from Medicare.