Medicare Cuts Impede Patient Ability to Heal at Home
by Timothy Rogers
Recovery following serious illness or injury is a delicate and crucial journey. The familiarity and comfort of one's own home play an immeasurable role in supporting the necessary steps in a patient’s rehabilitation process. Home healthcare is an indispensable service, especially for seniors, a demographic that overwhelmingly prefers returning home after a hospital stay.
However, years of continuous cuts to the Medicare home healthcare benefit have posed a significant threat to the well-being of countless older Americans and other vulnerable individuals in need of post-acute care. These cuts have adverse effects nationwide, but their impact is particularly pronounced in rural communities like many areas in North Carolina. Now that the federal government has once again proposed a sweeping multibillion cut to Medicare home health, Congress must take swift action to shield home healthcare patients and providers from these destructive impacts.
By blending medical services with the comfort and security of the home environment, home health agencies provide comprehensive healthcare that enhances the quality of life for patients. The recovery process for many patients is an uphill and often lengthy struggle, involving a multidisciplinary team of healthcare professionals.
If finalized, the government’s proposed -9.36% payment cut to Medicare home healthcare would exacerbate the challenges hospitals already face in discharging patients to recover at home. Existing healthcare workforce shortages are already straining the capacity of home health services and other post-acute care providers; further cuts could result in the loss of these services altogether, which would be devastating for hospitals operating near capacity and patients and families who strongly prefer to recover at home.
In North Carolina, home health agencies handle approximately 220,000 Medicare home health cases each year. If Medicare cuts $21.3 million in home health across our state in 2024, as proposed, it could seriously restrict the ability of our home health community to manage level of patient need and demand.
The loss of access to home healthcare is escalating into a crisis in North Carolina. A severe shortage of home health providers is already underway, as recent data estimates suggest that 12,000 more nurses will be needed in the next three years. Medicare's proposed cuts to the home healthcare program, totaling nearly 10% in 2024, would strip millions from North Carolina’s home health community next year. Nationally, these cuts could amount to a staggering $25 billion over the next decade. Given the pre-existing challenges faced by the home health sector, these cuts could fundamentally alter or even dismantle Medicare's home healthcare system, particularly in already underserved rural areas.
With approximately 87% of our home healthcare patients contending with three or more chronic conditions, I worry that Medicare’s proposed cuts could deprive some of our most at-risk seniors of essential treatment. The healthcare sector is already grappling with a provider shortage, leaving many patients without access to care. Putting even more strain on these critical post-hospital care services simply makes no sense.
Thankfully, members of Congress are taking action to address the erosion of Medicare's home healthcare program. The bipartisan Preserving Access to Home Health Act (S. 2137/H.R. 5129) offers hope to home health patients, families, and providers. If passed, this bill will safeguard Medicare's home healthcare program from cuts at least until 2028.
Home healthcare stands at a crossroads, with the well-being and access to essential care services for patients hanging in the balance. It is imperative that Congress act swiftly and pass the Preserving Access to Home Health Act. Seniors in North Carolina and throughout the nation have the right to heal and age gracefully in the comfort of their homes. Our lawmakers should help them.
Timothy Rogers is the President and CEO of the Association for Home & Hospice Care of North Carolina. Rogers has more than 30 years working in healthcare, primarily Medicare home health and hospice management.
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