Aging isn’t easy. And leaving home when healthcare needs require extra attention makes it even harder. But thanks to progress and innovations in the delivery of home health, more older Americans are able to stay safely at home while receiving home healthcare services.
Home health care is an essential component of the care system for our state’s seniors. It enables homebound seniors to receive medically necessary care under their own roof, including chronic disease management, rehabilitation and various therapies. However, recent changes to Medicare’s payment system will have a decidedly negative impact on Kansas seniors who rely on these care services to avoid nursing home stays or hospitalizations.
Under a new payment model, which will be implemented by the federal Centers for Medicare & Medicaid Services, reliable and consistent access to home health services for these vulnerable Kansans could be threatened. Under the new structure, called the Patient-Driven Grouping Model, Medicare will base its provider payments on “assumed behaviors” which means that assumptions will be made about the types of services being administered to patients rather than actual services that are carried out.
As the executive director of the Kansas Home Care & Hospice Association, I know the detrimental effects this policy will have not only for our state’s elderly and underserved, but for our healthcare industry as well. Across Kansas, the home-health industry employs more than 7,300 people. These home health workers deliver quality, compassionate care to more than 29,700 Kansans annually. Their jobs could be at risk under the PDGM, with payment cuts to Kansas providers under the new plan projected at almost 11%. Nationally, this payment reform cuts nearly $1.3 billion from the Medicare home health system in 2020 alone.
More importantly, on top of the decidedly negative impact this could have on our state’s economy some of our most vulnerable Kansans stand to be disproportionately affected by this change. Currently, 91% of our most at-risk Kansans who rely on home health care are living with three or more chronic conditions. To put this in perspective: out of all of the Medicare recipients in Kansas, only 10.4% have three or more chronic conditions, emphasizing just how in need these individuals who rely on home health are compared to other patient groups. This alone demonstrates why the policies to curb access to home health care are particularly harmful for seniors here in Kansas.
For this reason, I call upon Rep. Ron Estes to co-sponsor the Home Health Payment Innovation Act of 2019 (H.R.2573). This bipartisan legislation would refine the new payment model so that reimbursement from Medicare is based on fact, not assumption.
Sen. Pat Roberts is already supportive of this bill in the U.S. Senate (S. 433) – it’s time for the rest of our congressional delegation to follow his lead. By signing onto this important legislation, our lawmakers can recognize the value home health adds to the lives of Kansas seniors and ensure continued access to the patient-preferred, cost-effective care beneficiaries want as they age. Enabling seniors to remain in their homes can make aging just a little easier.