On Friday, November 3, the National Association for Home Care (NAHC) put an emergency advisory council meeting on the calendar to discuss some incredibly hot topics. During this meeting we heard loud and clear from our colleagues across the nation about the issues we are having with Medicare cuts, staffing shortages, and the extreme inability to safely accept and care for patients.
NAHC member Cindy Campbell, MHA-Healthcare Informatics, BSN, RN, WellSky, Senior Director Advisory Services had this to report:
CMS has asked us for data repeatedly. When we presented referral disposition data to them, along with our colleagues from HCHB, their response was essentially to dismiss it in light of their stance on industry profitability.
CMS Response: “We appreciate industry advocates’ dedication to ensuring continued access to home health services. We recognize there is always a level of concern that accompanies a payment rate decrease and we remind readers that, by law, as described in section 1895(b)(3)(D) of the Act, we are required to ensure that estimated aggregate expenditures under the HH PPS are equal to our determination of estimated aggregate expenditures that otherwise would have been made under the HH PPS in the absence of the change to a 30-day unit of payment and changes in case-mix adjustment factors. We appreciate providers’, beneficiaries’, and other stakeholders’ commitment to the sustainability of the home health benefit. As we noted above, we reprice the base payment rate based on actual behavior changes by HHAs, not on how the behavior changes impact HHA margins.”
The response then perseverates on industry Medicare profit margin.
“These high margins indicate that the increase in 9 Report to Congress, Medicare Payment Policy. Home Health Care Services, Chapter 8. MedPAC. March 2023. Payments in 2021 far exceeded the increase in costs, which undermines commenters’ assertion that CMS’s modest (by comparison) cuts to the base rate in 2023 would exacerbate any problems with access to care.”
We know we have an access to care issue!
As these federal issues become increasingly more important, we invite you to join OCHCH on Wednesday, November 15th for a federal advocacy roundtable. Details and registration are at this link.
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The WellSky® 2023 Evolution of Care Report, released July 25, 2023, reveals critical changes to care delivery in the past year. Based on proprietary data from WellSky’s CarePort solutions, which are used by over 2,000 hospitals and 130,000 post-acute care (PAC) providers, the report explores the ways care delivery has changed over the past year and sheds light on the implications for patients and providers as we enter a new era of post-pandemic healthcare. Read the full report here.
