Medicare cuts to home health impede patient care for Missouri seniors

September 8, 2023 5:50 am

If Medicare continues to chip away at funding, home health in Missouri and across the country faces a dire future (Getty Images).

When being discharged from the hospital after a severe illness or injury, most seniors prefer to return home and receive home healthcare.

However, Medicare’s ongoing cuts to the home health program threaten access to care for millions of older Americans and patients with disabilities in need of post-acute care who want to go home when leaving the hospital. These unnecessary cuts will not only undermine patient access but could also worsen a growing healthcare crisis in rural communities throughout southeast Missouri and across the state.

It is critical for Congress to prevent Medicare from enacting these devastating cuts.

Home healthcare exists to help ease the transition from the hospital back to patients’ homes. It can be a difficult process, which is why home healthcare agencies employ a comprehensive team of nurses, physical and occupational therapists, social workers, home health aides, and other compassionate healthcare professionals to help patients rehabilitate safely and comfortably in their own homes.

Unfortunately, an ongoing home healthcare workforce shortage and the impact of years of Medicare cuts to home health providers are making it increasingly difficult for hospitals and health systems to refer patients to home healthcare.

Here in Missouri, SoutheastHEALTH recently announced that it intends to discontinue its home healthcare service line in Cape Girardeau, Dexter and Stoddard counties, citing both of these issues as contributing factors for their decision. More cuts to Medicare’s home healthcare program will only exacerbate this concerning trend—with patients feeling the ultimate impact of agency closures.

In total, Medicare is proposing to cut more than 9% from the home healthcare program in 2024, which will total a $10.2 million cut for home health in Missouri next year. When combined with other cuts and financial pressures, data forecasts 70.2% of Missouri’s home health agencies will have margins below zero after the proposed 2024 cuts to home health.

When factoring in the cuts home healthcare experienced this year and last, these cuts will total up to $20 billion nationally over the next decade. Considering the significant challenges home healthcare already faces, this next round of cuts could signal the end of Medicare’s home health program as we know it—especially for rural communities where hospitals and health systems already struggle with limited resources and funding.

In Missouri, more than 57,000 older patients and patients with disabilities are covered by Medicare’s home health benefit. Roughly 85% of them have three or more chronic health conditions, meaning they are very vulnerable people.

More cuts to Medicare’s home health program could disrupt or cut off access to care for some of our state’s sickest, at-risk patients. This would be particularly true for patients in southeast Missouri, which has already been hit hard over the past several years by hospital closures, dwindling access to ERs, and a growing physician shortage. With home health next on the chopping block, where will these patients access the critical post-hospital care they need?

Fortunately for home health patients, families, and clinicians, bipartisan legislators in Congress are working to halt Medicare’s attack on the home health benefit by introducing the Preserving Access to Home Health Act (S. 2137/H.R. 5129).

If passed, this bill would prevent Medicare from implementing these, or any other, cuts to home health until at least 2028. It would also require MedPAC—a non-partisan agency that provides Congress with policy analysis and advice regarding Medicare—to gain a fuller understanding of the economics behind the home healthcare system to better support this critical benefit moving forward.

If Medicare continues to chip away at funding, home health in Missouri and across the country faces a dire future. Congress must pass the Preserving Access to Home Health Act —and, given his role on the House Ways and Means Committee, Representative Jason Smith should help ensure that happens as soon as possible.

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