Aging population underscores need to protect Medicare home health

Ohio will be one of 18 states flipping that scenario.

The rapid graying of our state — and our country — is hardly a surprise. What is surprising, however, is that Medicare is making considerable payment model changes to patient-preferred health care services seniors need to age in place.

Home health care, for example, is an extremely critical Medicare benefit that will only grow in importance in coming years as Ohioans age. Today, more than 122,000 Ohio Medicare beneficiaries depend on skilled, high-quality home health care to recover safely and comfortably following surgery, injury, or illness — and to help manage their serious chronic conditions at home. It’s a health care sector that’s cost-effective for Medicare and that employs more than 64,000 across the state.

So, health-care and aging advocates — including those of us at the Ohio Council for Home Care & Hospice — have become increasingly concerned about a home health care reimbursement policy that will have huge implications here and nationwide.

In 2018, the Centers for Medicare & Medicaid Services in Washington, D.C. developed a complex policy changing how providers of skilled home health care are paid. They had good intentions: fed up with wasteful spending, it was a policy intended to stop the loss of precious health care dollars.

Called the Patient-driven Groupings Model, the regulations would allow Medicare to make “behavioral adjustments” to provider payments based on assumptions about what caregivers might do instead of evidence of how they actually serve their Medicare patients.

Unfortunately, this policy created its own serious issue. CMS itself has admitted that the model will cut reimbursement rates for home health care across the board by 8.01% — or roughly $1.3 billion nationally in 2020 alone. In Ohio and from coast to coast, the real-life result will be significant cuts to home health care providers who are attempting to meet the growing needs of their clients.

That’s why my colleagues and I are joining many other advocates across Ohio in urging our federal lawmakers to put their support behind the Home Health Payment Innovation Act, pending in Congress as S. 433 & H.R. 2573 — which would protect Medicare beneficiaries’ access to the skilled home health care they need and deserve.

If passed, it would require Medicare to implement reimbursement rate adjustments only after CMS observes any billing behavior changes by home health agencies. It’s a logical and extremely important policy that uses facts, not assumptions, to reimburse health care providers for taking care of our seniors.

I recently had the honor of meeting with some of our federal lawmakers — including Congressmen Brad Wenstrup, a Republican from Cincinnati and Bill Johnson, a Republican representing eastern and southeastern Ohio — while they were home for summer recess to discuss the merits of this bipartisan legislation.

I urge all Ohio lawmakers to support this bill to ensure that Medicare’s new payment model is reformed before implemented to protect delivery of quality home health care.