Healthcare worker standing in front of a state capitol building

In a bluntly worded letter to Health and Human Services Secretary Xavier Becerra, LeadingAge President and CEO Katie Smith Sloan said the proposed Medicare payment cuts to home health providers run counter to the Biden administration’s pledge to support home- and community-based services. 

Katie Smith Sloan headshot
LeadingAge President and CEO Katie Smith Sloan

“Cutting Medicare home health payments by an aggregate 4.2% including a 7.69% negative adjustment to the base payment, coupled with an effort to cut an additional $2 billion from home health services, will have a devastating effect on older adults who rely on these services,” Sloan said in the letter. “Further, it runs counter to the administration’s stated goals of promoting equity and the use of home and community-based care.” 

The Centers for Medicare & Medicaid Services announced the proposed calendar year 2023 home health rule earlier this month. The proposed 4.2% Medicare payment cut would result in an estimated decrease to home health agencies of $810 million next year. It comes on the heels of the proposed 2023 0.9% payment cut to skilled nursing facilities, which would cost nursing homes an estimated $320 million. 

LeadingAge represents 5,000 nonprofit seniors service agencies. Sloan argued in the letter that the combined cuts to home health and skilled nursing would cause “devastation across the entire continuum of care” that would not “bode well for older people.”

“From our vantage point, the combined impact of the proposed payment cuts and current workforce and inflationary pressures would lead to waves of closures and the inability of providers that remain to take on new patients and residents,” Sloan explained. “The fragile long-term care ecosystem could simply cease to exist, especially our mission-driven, high-quality members.”  

Sloan questioned the administration’s decision to reduce funding to HCBS after President Joe Biden pledged last year to boost funding for those services by $400 billion. Funding for long-term care services was part of the administration’s Build Back Better plan, but that legislation stalled in the Senate late last year. 

Push-back on the proposed home health rule has been aggressive since CMS announced it. Last week, National Association for Home Care & Hospice President and CEO William Dombi threatened to circumvent the Medicare cuts with possible legislation or a lawsuit. 

The public has 60 days from the time the proposed rule was announced to comment on it. CMS is expected to announce the final rule in late October.