More and more Americans are choosing to age at home rather than in nursing homes or other facilities, so it’s no surprise that the number of home health visits in the U.S. is also on the rise.
But agency data shows that overall use of Medicare home health services has been declining over the past five years: In 2023, nearly 90% of Medicare beneficiaries eligible for home health benefits did not receive a visit from a home health aide.
AARP is urging the Centers for Medicare and Medicaid Services (CMS) to strengthen the Home Health Program. On August 26, we submitted feedback to CMS on the proposed Home Health Prepayment System Fee Update for Fiscal Year 2025. The proposed rule, a draft of the program’s 2025 rulebook, outlines how much funding home health agencies will receive from Medicare and what these agencies must do to be eligible to receive the funds.
In the 14-page letter, AARP urges CMS to improve access to existing services, expand services offered, and increase outreach and education to increase the number of beneficiaries using this home health care option.
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“Medicare beneficiaries often face significant and unnecessary barriers when accessing and using the home health care services they need,” wrote David Certner, legislative counsel and legislative policy director for government relations at AARP. “Addressing these concerns is especially important as our aging population grows and requires increasingly advanced levels of care.”
Here are some of AARP’s requests.
Integrating and supporting family caregivers
According to AARP research, roughly 38 million family caregivers in the United States provided a combined total of 36 billion hours of care to adult family members in need in 2021, equating to an estimated $600 billion in unpaid labor annually. Their role in providing in-home care to Medicare recipients is “critically important,” AARP wrote in its letter.
AARP supports CMS’ efforts to better integrate and support family caregivers in home health programs. For example, we support the proposal to add measures to home health agency performance reviews that assess their ability to meet the needs of family caregivers. We also support the expert panel’s recommendation to include family caregiver input in quality reports on home health providers.
“AARP believes that a key component of any policy effort is to ensure that home health benefits appropriately incorporate and support family caregivers who voluntarily assume that role,” Certner wrote.
