I’m not one to spout scientific theories, but it seems that Newton’s Third Law has particular relevance in the world of home care. As a reminder, the law states that for every action (force) in nature there is an equal and opposite reaction. Call me a flat-earther, but does this law not sum up perfectly the continuous tension between home care providers and the Medicare Payment Advisory Commission (MedPAC)?
Take last week’s MedPAC meeting. The group recommended a 7% Medicare payment cut to the home health base rate in 2024 due to Medicare margins of 24.9%. The recommendation would not have been so unusual had it not emerged during a particularly tense time for home care. While the MEdPAC meeting was taking place, the home health industry was working feverishly to include a delay to the 2023 3.925% cut in an end-of-the-year budget package.
While it is not yet clear what is in the budget package agreement, which lawmakers appear to have struck, MedPAC’s recommendation at the very least offered lawmakers pause about giving the industry a hand in pending legislation.
Home care providers certainly are not pleased with MedPAC’s calls of late — particularly as a labor shortage, pandemic headwinds and inflation continue to kick up dust for providers.
“The proposed recommendation by MedPAC to cut Medicare home health payment rates by seven percent is a continuation of MedPAC’s failure to utilize a method of assessing care access that fits within the real world of home health services,” NAHC President William A. Dombi said in a recent statement.
Dombi goes on to note that a portion of Medicare revenues help to subsidize the “less than cost” payment rates from Medicaid and Medicare Advantage. Slashing Medicare rates by 7% would hurt access to care.
“We call on MedPAC to incorporate this reality into their assessments and to join forces with the home health community to correct the systemic failure that leads to one government-based healthcare program subsidizing two others,” he said. “Home health agencies are at the mercy of Medicare Advantage plans and Medicaid programs on their own.”
No question MedPAC has an important and difficult role: It has to look at all the data and make calls to Congress about how to allocate precious and finite Medicare funds. It’s just too bad there’s so much pushback against an industry that already feels like it is in an uphill fight.
Liza Berger is editor of McKnight’s Home Care. Email her at [email protected].
