Protect Medicare patients’ right to get care at home

Anyone who is part of the sandwich generation as I am—raising twin boys while also caring for my 88-year-old mother-in-law—understands the challenges that come along with ensuring seniors can age with grace and dignity while still being able to access high-quality health care.

For millions of older Americans and patients with disabilities, home health care offers a safer, more comfortable, and more cost-effective solution for recovery after being discharged from the hospital. That is what makes the latest round of proposed cuts to Medicare’s home health services so alarming for our nation’s 3 million home health beneficiaries—not to mention their families and loved ones who care for them.

It makes sense that 9 out of 10 seniors and Medicare beneficiaries would prefer to receive short-term recovery or rehabilitation care at home rather than at a nursing center. Home health allows older patients and Americans with disabilities to access the critical health care they need in a familiar setting close to their family, friends and social networks. Not only that, but it also allows for more personalized care.

Yet, for all the benefits home health care provides patients, Medicare is once again singling out this vital program with devastating cuts that could threaten the ability of seniors to return home after hospitalization.

As it stands, Medicare home health care services for 2023 have already been cut by nearly 4 percent compared to the previous year. Now, Medicare is proposing another round of cuts that would total more than 9 percent beginning in 2024. Taken together, these cuts will slash $20 billion from Medicare home health services over the next decade. Make no mistake: these cuts will have a detrimental impact on patient access, while limiting patients’ ability to receive care at home.

At the same time, a recent report makes it crystal clear that Medicare’s cuts to home health services are a step in the wrong direction. The report, which examines how health care delivery has evolved over the past year, finds that hospitals are finding it increasingly difficult to transition patients out of the hospital and into post-acute care, including both home care and skilled nursing facility settings.

According to the report, as patient acuity has risen, the volume of home health referrals has grown by 11 percent in just the past year—continuing a trend that began in the pandemic. At the same time, the rejection rate by home health agencies has increased by 40 percent as staffing shortages, widespread burnout, and high turnover continues to pose significant challenges for the entire home health community.

As the demand for post-acute care rises, the answer to the problem hospitals face when trying discharge patients is not to cut payments to home health services even further. If anything, policymakers need to find a solution that improves access to home health services, not undermines it altogether.

Lawmakers in Congress understand this and are taking legislative steps to protect seniors and patients with disabilities from these harmful cuts. A bipartisan group of lawmakers—Sens. Debbie Stabenow (D-Mich.) and Susan Collins (R-Maine) along with Reps. Terri Sewell (D-Ala.) and Adrian Smith (R-Neb.)—have introduced the Preserving Access to Home Health Act (S. 2137/H.R. 5159) in both the Senate and the House.

This legislation addresses the harmful cuts to Medicare home health services that began this year and will continue until at least 2028. The bill would not only restrict Medicare from making any cuts to home health care, but it would also direct MedPAC—a nonpartisan, independent agency that advises Congress on Medicare payment policy—to study the issue further to help policymakers find a long-term solution.

Congress has limited time to act to prevent Medicare from moving forward with these dire cuts. Lawmakers on both sides of the aisle must work together to protect older Americans’ right to age at home.

Terry Wilcox is the co-founder and CEO of Patients Rising, a nonprofit patient education and advocacy organization that helps people get access to the diagnostics and the treatments they need.