President Obama’s proposed fiscal 2015 budget would have a heavy financial impact on home health agencies.
 
Replicating the budget the president proposed a year ago, the latest proposals — sent to Congress on March 4 — call for a home health copay, a 1.1 percentage point reduction in each year’s inflation updates from 2015 through 2024 and at least half of home health reimbursement in the form of a fixed bundled payment.
 
Adoption of the president’s proposed cuts would mean 41% of all agencies are caring for patients at a loss this year and 60% in 2017, the National Association for Home Care & Hospice predicts.
 
Because of the bipartisan two-year budget Congress approved for itself in December, neither the Democrat-controlled Senate nor the Republican-controlled House is displaying any interest in reopening the issue in an election year. The risk for the industry, home health executives fear, is that copays and other home health savings could be used to help pay the cost of replacing replace Medicare’s sustainable growth rate (SGR) formula for paying physicians — now $138.4 billion over the 11 years through 2024, according to the latest Congressional Budget Office estimate.