My grandma lived on top of a hill overlooking the magical mountains and valleys of the Ozarks until the day we literally had to drag her out of her. Our family was spread out in Texas and California working full time so no one could check in regularly. When she had home health workers, they helped with her medication and recovery from shoulder surgery. Overly friendly neighbors also helped by changing her will and emptying her bank accounts – a story for another day.
Older Americans want to take care of it in their homes as long as they can. But this is not always possible, especially when families are scattered. Home health care workers make such care a reality for many families, including mine. I’m part of the sandwich generation: I raise 9-year-old twin boys and help take care of my 87-year-old mother-in-law, who lives with us. Before my father-in-law died, he had his wounds painted right in my living room. My stepdaughter was diagnosed with Alzheimer’s and needed support to stay in her own home before she was finally placed in an assisted living facility five miles from my home.
Home health care offers some advantages for older Americans. This allows them to receive care in the comfort and familiarity of their homes, close to established friends and social networks. It offers personalized care and greater independence. And it’s often more cost-effective than a nursing home. Home care also allows older Americans and people with disabilities to recover more quickly from serious injuries or illnesses with less exposure to hospital-based infections and readmissions.
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Despite the popularity and advantages of home health care, access to it is being threatened by deep proposed cuts to Medicare.
In his last the proposed rule, Medicare is considering implementing a nearly 8% permanent cut in payments for home health services. That would mean $1.33 billion in 2023 alone, another $2 billion starting in 2024 through a rollback for services provided to seniors and people with disabilities during the first two years of the Covid-19 pandemic, and about $1.2 billion in rollbacks for services provided in 2022. These cuts, which could amount to an estimated 18 billion dollars over the next 10 years, it would be a devastating blow to more than 3.5 million people whose home health care is covered by Medicare.
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After ensuring the health and safety of older Americans during the worst public health crisis in 100 years, why is Medicare trying to reduce access to home care and also roll back payments for what made it rights and entitlements?
An analysis suggests that cuts and clawbacks could put 44% of America’s health agencies at risk of closing, seriously jeopardizing beneficiary access to care, especially in rural and underserved communities. This policy just doesn’t make sense.
The population of Medicare home health beneficiaries has grown up and sick. More than 25% of home health users nationwide are over the age of 85, and 43% have five or more chronic health conditions, compared to only 22% of all Medicare patients. That means these cuts will target some of the sickest and most vulnerable older Americans.
These cuts will further limit access to home health care, which is already being stretched by growing demand as many Americans want to stay out of the hospital to avoid contracting the coronavirus and other infectious diseases and getting worse from a lack of home health workerslit in part by low salary.
Advocates for the elderly must be stepped up to protect access to home health services. Lawmakers in Congress have introduced the Preserving Access to Home Health Care Act of 2022 (HR 8581 AND S. 4605). This bipartisan legislation, currently before the House and Senate, would prevent Medicare from imposing these cuts until 2026, ensuring people have continued access to care and giving providers the stability they need as Medicare seeks more plenty of time to improve its payment system.
or the last poll conducted by Morning Consult found that 97% of Medicare beneficiaries want the federal government to maintain Medicare coverage for home health care, and 88% believe it is important for Congress to pass legislation that would stop proposed cuts in payments to Medicare home health services. Almost everyone affected by this harmful policy wants something done.
Those who need health care covered by Medicare deserve access to care in the setting of their choice. More than 90% of the elderly say they prefer to receive continuing care or short-term care for recovery or rehabilitation in the safety of their homes. By supporting the Preserving Access to Home Health Act and bringing it to passage over time, Congress can protect home health patients and provide stability within the home health community as demand grows.
Terry Wilcox is the co-founder and CEO of Patients Rising, a nonprofit patient education and advocacy organization that helps people access the diagnostics and treatments they need. Increasing patients is one of 13 organizations that have urged Congress to pass the Preserving Access to Home Health Care Act of 2022.
