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House Bill Could ‘Fast Track’ Medicare, Medicaid Cuts, Senator Warns
McKnight’s Home Care | By Adm Healy
A bill advancing through the House would create a process to expedite major fiscal policy changes, including cuts to the Medicare, Medicaid and the Social Security program, according to Sen. Ron Wyden (D-OR), Senate Finance Committee chair.
The Fiscal Commission Act would create a commission of experts tasked with identifying strategies for the United States to “improve the fiscal situation in the medium term and to achieve a sustainable debt-to-GDP ratio of the long term,” according to the bill’s text. The group, made up of both legislators and “outside experts,” would recommend ways that federal programs such as Medicare or Medicaid could improve their solvency over the next 75 years.
“The term ‘fiscal commission’ is the ultimate Washington buzzword, and it translates to trading away Americans’ earned benefits in a secretive, closed-door process,” Wyden said in a Jan. 18 statement.
Rep. Bill Huizenga (R-MI) and 13 others, a mix of Republicans and Democrats, introduced the bill last Sept. 28, and the number of cosponsors has since grown to 24. The House Budget Committee approved the bill on Thursday, moving it further towards official passage by the House.
Wyden argued that the creation of such a fiscal commission would allow program cuts to be rushed through the legislative process.
“The proposals … would fast-track cuts to Social Security and Medicare,” he warned in a statement, “and allow a handful of legislators and unelected political insiders to trade away Americans’ earned benefits in a secretive, closed-door process.”
He also requested that certain federal benefits, including Medicare and Medicaid, be barred from consideration by any fiscal commission. However, the House Budget Committee approved the legislation without such a provision.
“No one should be trying to claw back Americans’ earned Social Security and Medicare benefits,” he said. “I urge Speaker [Mike] Johnson to take Social Security, Medicare and Medicaid off the table as part of any proposed fiscal commission.” |
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Another ‘Doomy, Gloomy’ Home Health Landscape Awaits Providers In 2024
Home Health Care News | By Andrew Donlan
Home health providers could be facing a “doomy, gloomy” landscape in 2024, fresh off of two years that could be characterized as, well, doomy and gloomy.
On Monday at the Home Care 100 conference in Scottsdale, Arizona, Partnership for Quality Home Healthcare CEO Joanne Cunningham tried to emphasize the positives, while also recognizing the realities.
In particular, she harped on the need for the Preserving Access to Home Health Act to pass. The bill was introduced in the Senate in June, and in the House in August. A similar bill was also put forth in 2022, but failed to gain traction.
“If things don’t change with regard to payment policy, we will see a very doomy, gloomy future of the PDGM payment stream,” Cunningham said. “I don’t think I’ve ever said it this emphatically, but we must see this legislation pass.”
The legislation would mitigate further cuts to fee-for-service home health payment cuts and any future payment “clawbacks” from the Centers for Medicare & Medicaid Services (CMS).
In addition, it would force the Medicare Payment Advisory Commission (MedPAC) – which regularly recommends additional cuts to home health payments – to view home health margins more holistically.
“All of those [cuts] need to be wiped away,” Cunningham said. “This is also really important. In the legislation, we require MedPAC to do a better analysis of the financial condition of home health agencies right now. They take a very skewed look at the fiscal picture and financial stability picture of home health agencies.”
Part of the reason that view is skewed is because MedPAC does not include Medicare Advantage (MA) reimbursement for home health services, which tends to be considerably lower than fee-for-service reimbursement from CMS.
On that note, MA remains one of the hot-button issues in the home health industry.
Ironically, MedPAC also could finally be directing some of its scrutiny toward MA plans as well, Cunningham said.
“The MedPAC staff recently presented a report that essentially said that, [according to their calculations], in 2024, CMS will be overpaying MA plans to the tune of $88 billion,” she said…
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Support S. 2137/H.R. 5159 to Save the Medicare Home Health Program
Two weeks ago, NAHC & The Partnership held a Medicare Home Health Staff Briefing regarding the Preserving Access to Home Health Act of 2023 (S.2137/H.R. 5159). Here are the leave-behinds, including the testimonials, that were shared:
- To download Ms. Edwards' presentation, CLICK HERE.
- To download Ms. Massey's presentation, CLICK HERE.
- To download the Home Care Chartbook 2023, CLICK HERE.
Passage of this legislation is imperative to ensure the continued functioning of the Medicare Home Health Program
Please click on the following link to send a message to your representatives, and then share it with staff, colleagues, family, friends and your social media outlets.
https://p2a.co/8IGAgf7 |
Take Part in Home Care Pulse Study of Home-based Care
Every year, HCP performs the largest annual study on home-based care, home health, and hospice and publishes the results in its 200+ page HCP Benchmarking Report. This year marks the 15th year the report will be used by organizations nation[1]wide to benchmark their performance against industry standards, learn best practices from the experts, and make more informed decisions.
As a survey participant, you won’t just be helping the industry, you’ll also discover valuable insights about your own business as you reflect on your 2023 survey data.
HCP is offering a free digital copy ($999 value) and a $1,000+ savings on a physical copy to everyone who signs up to participate in the survey by February 9th.
Learn more: Participate - HCP Benchmarking (homecarepulse.com) |
How Home Health Providers, Payers Are Adapting to New Referral Patterns
Home Health Care News | By Patrick Filbin
Prior to the COVID-19 pandemic, it wasn’t uncommon for home health agencies and other post-acute care providers to beg hospitals to be a part of their post-acute networks.
Three years later, that’s generally not the case. The referral patterns in home-based care have seen a radical shift, and agency leaders are still adjusting to those changes and making adjustments on the fly.
“We were used to hearing from hospitals that we had to have a five star rating, have to have a medical director and all these other ancillary services,” Health Dimensions Group (HDG) CEO Erin Shvetzoff Hennessey said at Aging Media Network’s Continuum conference in December. “Now, the hospitals are realizing that the patients that they need help discharging don’t always fit into this five star model. These are difficult patients and sometimes difficult patients result in survey activity that doesn’t move you into the five star category. So, if you start to create this preferred provider network, it gets a little too preferred — and they need post-acute care to take these patients and to clear the hospital out.”
HDG operates a portfolio of 25 senior living communities across eight states. It also has a major contingent of skilled nursing properties.
Hennessey said that, because patients being discharged from the hospital are more complicated than they were before, two different referral groups are starting to emerge.
On one side, there are the five star referral partners who meet all the certain metrics that hospitals like to see.
“And then there’s this off-to-the-side network where we know that discharge planners are really connecting with post-acute,” Hennessey said. “These are the providers saying yes. Now we have this formal network and this informal network that’s actually getting patients moved.”
Referrals to home health care have been on a steady increase over the last three years. At the same time, providers are rejecting them at an unprecedented rate…
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