The Centers for Medicare and Medicaid Services (CMS) is expected to release the 2024 Home Health Final Payment Rule any time soon.
In anticipation, home health care providers and advocates have been lobbying Congress, educating and calling for action on social media and elsewhere.
All of these efforts are the latest push from an industry that has been vocal in its opposition to the proposed rules announced in June.
Home Health Care News recently spoke with many of these providers and advocates to learn more about what they are doing to push for a more favorable final rule.
At this time, we are focused on coordination between the White House and Congress, calling for a moratorium on the proposed rate cuts in 2024. Our allies in Congress are working on our behalf in this regard. We also hedge our risks by preparing Congressional efforts to block cuts during the budget process. We need to do everything we can to help, especially home health agency staff, including contacting local Congressional delegations.
— William A. Dombe, President, National Home Care and Hospice Association
With the final rule quickly approaching, Bayada Home Health Care has worked hard to mobilize our employees and advocates to make our voices heard in Congress. In coordination with PQHH and NAHC’s industry-wide efforts, advocates called and emailed federal lawmakers and published an op-ed urging them to support the Maintaining Access to Home Health Care Act. Additionally, Hearts for Home Care, Bayada’s 501(c)4 advocacy arm, posted on social media to further reinforce our message that stopping CMS requires action from Congress. I am active online and in person, traveling to Washington, DC. He proposed cuts to Medicare. We are hopeful that our positive conversations with our members have recognized our efforts and helped advance the needle on behalf of the entire home health community.
— David J. Totaro, Bayada Home Health Care Chief Government Affairs Officer
Last year’s reductions in home health costs forced many healthcare providers to make difficult decisions to keep their organizations afloat, from downsizing their service areas to laying off staff. If this year’s proposed 2.2% cut in home health benefits is finalized, providers will need to prepare for a similar impact in 2024. We urge CMS to postpone this year’s cuts while we continue working toward permanent relief.
For example, we see opportunity in ensuring that home health value-based purchasing (HHVBP) models focus on the appropriate means of care. We also see Congress showing interest in holding Medicare Advantage plans accountable. This is becoming increasingly important to both providers and the system as a whole as home health episodes increase in Medicare Advantage. The plan must cover the actual cost of the service.
We have already begun working with members of Congress to reimagine how home health benefits should work. We know they care, as evidenced by last month’s Senate Finance Committee hearing and the introduction of the Maintaining Access to Home Health Care Act of 2023, which we support. Masu. While there is incredible support for these services, CMS says their hands are tied when it comes to payment methods. Change is needed to best support the beneficiaries who need these services most, especially those in rural and underserved areas. We believe that developing payments to support providers serving these communities is invaluable. We are also looking at ways to better track actual access to home health services. MedPAC’s current definition of access is failing millions of Americans. It’s time to rethink what true access means in terms of choice, service, and location.
— Mollie Gurian, LeadingAge Vice President of Home and HCBS Policy
Looking ahead to the final rule, the Partnership and its members are using every tool in their toolbox to influence the outcome of the 2024 HHPPS. We are the White House, HHS, CMS, and OMB. We are working with advocates in Congress to pressure the Biden administration. We mobilized a wide grassroots army and called on Congress to use its power to stop the proposed cuts. We are working with NAHC this week to strengthen social media conversations among advocates and working with our state association partners to elevate this issue at the local level. It is important that all home health workers speak out now and speak out about how these cuts will negatively impact patient care.
If this rule is finalized, the partnership will address the impact on access to care for the Medicare population and ensure that providers can meet the high demand for home health services that has declined under the weight of the cuts. We plan to evaluate the impact it will have on We recommend that you carefully analyze the final rule to determine whether CMS has taken steps to eliminate or significantly reduce the proposed significant reductions. Home health care has already been cut by billions of dollars since 2020, and the market basket is woefully inadequate to cover the costs of inflation. We and the entire caregiver community will redouble our efforts to seek durable legislative solutions to stabilize home health care and protect access to care for the most vulnerable members of the Medicare population. I’m ready. The future of home health programs depends on these efforts.
— Joanne Cunningham, CEO, Quality Home Healthcare Partnership
We are working on a multi-pronged approach to minimize the disadvantages of the final payment rule for home health care. We leverage our extensive network and resources to layer advocacy efforts from the grassroots to the field, engaging our 1,000 employees as well as education and technology tools for the industry. We help providers prepare for any outcome by equipping them with the knowledge and tools they need.
Additionally, Axxess is committed to the viability of the industry and to making home health care available to all. We leverage our political action committee, Axxess PAC, to support the unified voice and work of national organizations, ensuring our advocacy efforts are amplified and impactful.
We encourage providers to stay informed and engaged as they prepare for the possibility of an adverse final rule. By partnering with industry associations and leveraging resources like Axxess PAC, healthcare providers can work together to influence positive change and protect the interests of the home health community.
— Deborah Hoyt, Axxess Senior Vice President of Public Policy
Between now and the issuance of the final rule, EnHavit Home Health & Hospice (NYSE:EHAB) will continue to update its customers on what we know is that patient access to home health care is being affected by continued cuts to Medicare. We are focused on drawing as much attention as possible to the truth that is true.
In August, our public comment letter and many others highlighted to CMS what the impact means for patients and health care providers. And in September, a home health care expert testified to Congress as much. And here in October, we are working to focus the Biden administration’s attention on what would happen if CMS moves forward with a proposal to further reduce Medicare home health benefits. Our elected officials must recognize the impact of the CMS proposal, considering priorities such as health equity, increasing access to quality health care, and avoiding cuts to Medicare. And importantly, administration officials should know that CMS has the discretion to depart from the agency’s proposal based on existing authority.
In addition to these efforts, we have many wonderful people from all over the country, many of whom work in home health care, who understand the importance of this moment. They are taking the time to call Capitol Hill and write letters to their members. Parliament and even writing op-eds in local newspapers are part of a region-wide effort to signal to government that these proposed cuts should not be finalized.
In preparing for the final rule, local leaders remain focused on managing resources and continuing to provide high-quality care in the most efficient manner.
— Andrew Baird, Vice President of Government Affairs and Policy Advisory at Enhave Inc.
Home health care is the foundation of home health care. The benefits over the years have opened the door to a broader way of thinking about what can be done at home. Innovations such as home hospitals, home SNFs, and home services such as home dialysis and home infusions would not be possible without the foundation that home health care provides.
We cannot allow this foundation to be undermined as we look to a future where older people are steadily aging and higher quality services are provided at home. Although the reimbursement structure is different, the new care model relies on the precedent and foundation set by home health benefits. As healthcare providers look at the possibility of unfavorable rules, it is important to share data and patient stories to paint a full picture of the negative impact of further reducing this valuable benefit.