Home Health & Hospice Week

Medicare reimbursement cuts are unprecedented, commenters say.

After years of reimbursement reductions and added regulatory burdens, HHAs are fed up — and they weren’t afraid to tell CMS about it.

"These proposed revisions will have devastating consequences for Medicare agencies," warns one Texas provider commenting on the PPS proposed rule published in the July 3 Federal Register. "Under rebasing … 75.3 percent of agencies in Texas will be reimbursed for less than the cost of doing business by 2017. It would effectively mean the closure of more than half the Medicare home health agencies in Texas."

"I know of no other industry that would be expected to operate at such drastic reductions in reimbursement," the commenter concludes.

"The rebasing cuts you are proposing will make it next to impossible for us to do our job," says an HHA Rehabilitation Program Manager in New Hampshire. The cuts "make it impossible to do YOUR job of providing quality healthcare to our citizens," the commenter adds.

"To propose cuts that will put the majority of Home Health Agencies out of business is insane," says another Texas HHA commenter. "Home Health is proven to save Medicare … billions of dollars each year. Putting agencies out of business is bad for the patient, bad for their care and will increase the risk for rehospitalizations exponentially, which of course cost Medicare a huge amount more than Home Health care."

"The idea is to save Medicare money, not have it be a net increase in spending," the HHA adds. "Please do the right thing for patients, the health care sector, for business and for Medicare as a whole."

"I have never seen a time when our sector faced such devastating funding cuts," National Association for Home Care & Hospice’s Val Hal-amandaris says in a release. "The Administration and Congress must not ignore the realities of this proposal and the real threat it poses to the future of home health delivery in America. These proposed cuts will result in reduced patient access to cost-effective healthcare — the exact opposite of what the Affordable Care Act set out to achieve."

The proposed cut will impose net operating losses on 47 of 50 states and the District of Colum-bia by 2017, Halamandaris notes. That will render many HHAs "inoperable." Nationally, the Medicare home health margin will drop to -9.77 percent.

"A reduction of 14 percent is unjustified from a data perspective, will curtail access to care for many vulnerable patients and is in direct conflict with the goals of health care reform to improve outcomes and beneficiary health and keep the cost of health care down," the Visiting Nurse Associations of America says in a release.

"It doesn’t make sense what (Medicare) is doing," Henry Ford Home Health’s Greg Solecki told Crain’s Business Detroit. "What we have is a pretty antithetical approach to what we thought we were supposed to be working on: putting an emphasis on the lower-cost provision of home health services to keep patients from being readmitted to the hospital."