One piece of good news in the latest Medicare trustees’ report is that home health no longer is one of the reasons for a rapidly depleting Medicare’s Part A trust fund. In fact, the fund will remain solvent through 2030, or four years longer than the trustees predicted last year, the report states.
 
In line with the overall projection of slower growth in Medicare’s per capita spending, growth in fee-for-service costs of home health actually will shrink by 0.2% in 2014 and resume growth with a 0.4% gain in 2015, rising to by 5.1% to 5.5% in 2018 through 2023, the report predicts.
 
The amount of home health outlays funded by the Part A Hospital Insurance (HI) trust fund, moreover, is far smaller than the outlays covered by the Part B Supplementary Medical Insurance (SMI) trust fund. Part A, which is funded by the Medicare payroll tax and covers for post-hospital episodes, paid out $6.8 billion for home health claims in 2013, compared with the $11.5 billion drawn from Part B, the trustees reported. Part B outlays, which pay for home health referrals from the community and long-term stays beyond 100 visits annually, are 25% funded by beneficiary premium payments and the balance by congressional appropriations.
 
As also reported by the trustees, Medicare enrollment reached 52.3 million individuals last year — 43.5 million of them age 65 and older and 8.8 million with disabilities. Of the total, 28% chose enrollment in Medicare Advantage plans over standard fee-for-service Medicare.