Nurse with elderly woman on wheelchair at home

Home health referrals skyrocketed by 123% in May compared to 2019, according to a new report by healthcare technology firm WellSky. At the same time, the referral rejection rate from home health agencies grew to a high of 71% between 2019 and 2022.

Lower Medicare payments under the Center for Medicare and Medicaid Services’ Patient-Driven Groupings Model made it tougher for home health providers to hire additional staff to meet the demand, according to WellSky Chief Clinical Officer Tim Ashe. He told McKnight’s Home Care Daily Pulse CMS’ proposed 4.2% payment cut for 2023 could make it even harder for agencies to accommodate patients in need of home healthcare.

Tim Ashe

“A decline in revenue or rate pressure reduces the ability of providers to make investments in staff, in education, in benefits, in technology and solutions that at the end of the day strengthen the ability of the industry and individual providers to be able to take care of increased demand and create efficiencies, which will improve quality outcomes and over time reduce the total cost of care,” Ashe said. 

Gaps in care for patients who are unable to access home health or skilled nursing following a hospital stay could lead to higher hospital readmissions, the report said. Still, Ashe predicted that home health providers will find ways to get around staffing challenges by investing in technology that would allow for increased telehealth visits and remote patient monitoring.

“Even though that is an additional cost, ultimately it creates efficiencies for clinicians and allows for more patients to be monitored and remain safe at home using technology in other ways, in addition to boots on the ground,” Ashe explained. 

The report noted that hospitals have been keeping patients longer due to the scarcity of post-acute care. Many of those who made it into home health over the past two years also tended to be sicker. The report found a 25% increase in patients with hypertension and a 34% increase in patients with diabetes.

WellSky accessed data from more than 1,000 hospitals and 130,000 post-acute providers for the report, in addition to data from CMS. The company researched admissions, discharges, transfers and referrals.