Two Republican senators are urging the Centers for Medicare and Medicaid Services (CMS) to maintain the interests of Medicare Home Health Organizations (HHAs) to “use full authority under the law.”
Senators Marsha Blackburn (R-Tennessee) and Susan Collins (R-Main) wrote to CMS administrator Dr. Mehmet Oz to raise concerns about the future of profits, including payment cuts that could shut down more HHAs. Home-based care advocates praised the message, saying policymakers must take action to protect their interests.
In 2018, the Bipartisan Budget Act (BBA) directed the CMS to develop a new payment model for the HHA from January 2020. Congress mandated that the model was budget-neutral, and the Congressional Budget Office showed that changes in payment methods did not cause differences in program spending.
As a result, the patient-driven grouping model (PDGM) began in January 2020. Implementing this new model, CMS reduced HHAS payments. CMS cuts funds each year, leading to delayed start of care, fewer home visits and lower benefits, Blackburn and Collins said.
Blackburn and Collins said budget cuts erode access to the benefits of home health care, and the HHA has “has been having problems” as it has closed or reduced service areas accordingly.
“We will use full power under the law to suspend planning cuts for HHAS' CY 2026 Proposed Rules and allow clinician experts, seniors and their families and CMS to discuss improvements to systems that will maintain care, improve quality and reduce growth in healthcare costs,” the senator wrote. “We believe it is essential to do so in order to maintain this important benefit and ensure that older people continue to receive care where they want to be the most.”
In conclusion, the senator asked for a response by July 7th.
The letter has been supported by the National Alliance for National Alliances at Home.
“The Alliance is deeply grateful to Senator Blackburn and Collins for their continued leadership and advocacy on behalf of the millions of seniors who rely on Medicare's home health services,” Dr. Steve Landers, CEO of the Alliance, said in a statement. “The most cost-effective care setting, CMS's reductions in home health reimbursement are pushing older adults into hospitals and expensive facilities, increasing taxpayer costs, and undermining patient outcomes through increased readmissions and mortality.”
He suggested that policymakers focus on expanding value-oriented innovation rather than implementing addressing fraud and abuse and overall board reductions.
“We must now focus on keeping our patients healthy and safe, maintaining and protecting this essential benefit of being at home with our families,” he writes.
