Home Health & Hospice Week

Payment:

MedPAC Commissioners Express Enthusiasm For Home Health Copays

Medicare beneficiaries don’t have enough skin in the game, advisors to Congress argue.

Watch out: Another campaign to implement cost sharing for Medicare home health may be afoot.

In the Medicare Payment Advisory Commission’s Dec. 8 meeting, multiple commissioners voiced support for instituting home health cost sharing.

“Home health has no cost sharing right now for beneficiaries, and I think that could really help here,” offered Commissioner David Grabowski, a professor in the Department of Health Care Policy at Harvard Medical School. “I really like this idea,” Grabowski enthused.

“I strongly support cost sharing in this and every sector,” declared Betty Rambur, professor in the College of Nursing at the University of Rhode Island. “It’s always important for people to have skin in the game and prevent moral hazard,” Rambur opined. “I think it’s actually really important and very valuable,” she emphasized.

“Medicare beneficiaries need to have more skin in the game, and I strongly support having cost sharing on home care,” said Commissioner Kenny Kan, chief actuary of Horizon Blue Cross Blue Shield (BCBS) of New Jersey.

“I strongly support cost sharing,” Commissioner Lynn Barr, a rural health expert and founder of Caravan Health, chimed in.

Patient Refusal Of Care A Real Threat

But one commissioner, nurse Marjorie Ginsburg, pointed out why home health copays are not necessarily a slam dunk.

“I was a home care nurse back in the ‘70s. I was a supervisor back in the ‘70s,” said Ginsburg, founding executive director of the Center for Healthcare Decisions Inc. “I was always very opposed to cost sharing for home care, and my main reason is I was afraid — and I think I still am … that people will turn it down,” Ginsburg shared.

“They don’t turn down going to their doctor’s office” and “they don’t turn down any cost sharing they might have for the hospital, for any other aspect they know they need,” Ginsburg said. “But if home care involves a nurse, a PT, maybe even an OT, my concern is they’ll say ‘Oh, I don’t want to pay the 20 bucks,’ or whatever, ‘I think I’m fine.’ Or they’ll cut it off earlier than they need to.”

While it’s too late to add cost sharing to the advisory body’s recommendations under consideration for 2023, don’t be surprised to see it pop up in the future, observers warn.

Other Articles in this issue of

Home Health & Hospice Week

View All