Just in time for Halloween, the federal government released a final home health rule. While it may not have risen to the level of horror, it still managed to spook the industry.
In its final rule revealed Monday, the Centers for Medicare & Medicaid Services presented an expansion of Medicare payments for calendar year 2023 of 0.7%, or $125 million, compared to 2022. This figure reflects a 4% market-basket update, or $725 million; a behavioral adjustment of -3.925%, a $635 million decrease; and a small uptick of 0.2%, or $35 million increase.
On its face, the rule seems much more attractive than the one proposed months ago, which threatened to cut Medicare payments by a whopping 4.2%, or $810 million, and included an onerous behavioral adjustment of -7.69%, a $1.33 billion decrease. Still, the final rule comes with a catch — namely that the behavioral adjustment for 2023 represents just half of the total -7.85% behavioral adjustment that CMS will impose.
It is this total adjustment, even though it is not going into effect all at once, that providers are vehemently against.
“Even with the limited phase-in of the rate cut, with significantly rising costs for staff, transportation and more, home health agencies across the country cannot withstand the impact of rate,” said Bill Dombi, president of the National Association for Home Care & Hospice, in a statement.
Joanne Cunningham, CEO of the Partnership for Quality Home Healthcare, agreed.
“This 7.85% cut is worse than initially proposed, and when enacted in 2024, will result in an immediate decline in access to home health,” she said in a statement released immediately following the rule. “This will have negative effects on the availability of care for the most chronically ill of the Medicare population and result in access to care problems. While this short-term phase-in blunts the immediate impact, the long-term consequences of this rule, unless mitigated, will devastate access to care in the home.”
Both organizations are looking to Congress to pass the Preserving Access to Home Health Act of 2022, which would delay Medicare cuts until 2026.
There are no straight-forward answers on this one. Given the paralyzing effect of the midterm elections, respite from Congress may not be on the immediate horizon. It is certainly not an easy time to be a home health provider. Then again, is it ever?
Liza Berger is editor of McKnight’s Home Care. Email her at [email protected].