Pointing to wide margins it sees for home health providers under Medicare Fee-For-Service, MedPAC is poised to call for a 7% payment cut for agencies in its next recommendations to Congress.
 
The commission that provides guidance to legislators on Medicare spending is expected to finalize the recommendation early next year ahead of a formal submission to Congress next spring.
 
MedPAC staff noted that the FFS Medicare marginal profit on home health care was 23% in 2022, down from 24.9% in 2021. The estimated margin for all payors was at 7.9%, down from 11.9% in 2021.
 
The National Association for Home Care & Hospice (NAHC) and the Partnership for Quality Home Healthcare (PQHH) called MedPAC’s approach flawed and inaccurate in a statement.  
 
“There are many shortfalls in MedPAC’s home health margins report — starting with the fact that MedPAC’s analysis only captures a declining fraction of the Medicare home health population,” said Joanne Cunningham, the CEO of PQHH.
 
The figure presented by MedPAC “runs the risk of dangerously misleading policymakers who rely on MedPAC to inform their decisions,” she said.
 
NAHC and the PQHH are calling on MedPAC to include an analysis of all-payor margins, and they note bipartisan legislation in Congress would require MedPAC to be more transparent in its calculations, including a report on the aggregate trends under Medicare Advantage, Medicaid and other payors.
 
“When policymakers don’t receive accurate information, they risk making policy decisions that have unintended, yet negative, consequences on beneficiaries,” said Bill Dombi, president and CEO of NAHC. “We hope that MedPAC can address our concerns about how it came to its erroneous conclusions in this presentation and work to provide stakeholders with more accurate, reliable, transparent, and actionable data.”