Home Health & Hospice Week

HHAs are closing over MA surge, commissioner acknowledges.

The Medicare Payment Advisory Commission may not have put any presents under home health agencies’ trees this year. But commissioners did ask some pointed questions about a very vexing — and growing — problem.

In its Dec. 8 meeting, Commissioner Cheryl Damberg with the RAND Corp. in Santa Monica, Calif., asked why home health cost reports didn’t include Medicare Advantage data.

MedPAC staffer Evan Christman responded that the home health cost report “is a legacy document that has been used for many purposes over the years, and I don’t think there has been a policy salience around tracking Medicare Advantage payments and costs,” according to the meeting transcript.

“I think the salience is much stronger now,” Damburg said.

“We’re seeing a lot of home health agencies close because with increasing Medicare Advantage population[s], they can’t make the math work,” offered Commissioner Betty Rambur with the College of Nursing at the University of Rhode Island. “Does that affect or influence how we think about this recommendation or not?” Rambur asked.

MedPAC Chair Michael Chernew with Harvard Medical School in Boston noted that commissioners may be frustrated with making recommendations for effectively half of the Medicare program, since FFS benes make up about that ratio. But figuring in MA stats is “outside of the criteria we have typically used” and “requires more analysis than the update work typically is,” Chernew maintained.