Margin pressure from the proposed reduction in Medicare home care rates can affect palliative care and hospice.
In June, the Medicare & Medicaid Service Center (CMS) in the United States announced a home care reimbursement rule proposed in 2023.
Authorities cited budget-neutral requirements to explain the reductions and adjustments related to the new payment system introduced in 2020, the Patient-Driven Grouping Model (PDGM). Declaration of war that threatens their sustainability. ”
However, in addition to the threat to core businesses, the rules if finalized could have a shrinking effect on these companies’ current or future hospice or palliative care programs, according to the National Home Care Hospice Association. Chairman Birdonbi said.
“Certainly, lower income from home health care makes it much more difficult to implement new programs such as palliative care and participate in innovations such as hospice. [value-based insurance design demonstration], And as the demand for higher rewards increases, it will affect the ability of providers to hire and retain staff for their programs, “Donbi told Hospice News. “In some situations, a decline in home health care revenue may lead to the use of hospice revenue to subsidize other programs rather than continuing to invest in hospice improvements such as technology.”
In addition to hospice and palliative care services, many providers offer home health care, from large publicly traded companies to nonprofits. Increasingly, home healthcare companies are trying to expand their business lines across the care continuum.
To make matters worse for these organizations, the proposed payment cuts occur when supply, labor, gas and travel costs, and wage costs are confirmed when they are skyrocketing.
Also, from July 1st, the COVID-19 pandemic interrupted Medicare’s quarantine and then resumed it. This means that both home health and hospice programs have reduced Medicare payments by a total of 2%.
Even providers, including hospice, who expect higher payments from Medicare, claim that the proposed rates are not sufficient given the rising costs.
The CMS has proposed a 2.7% wage increase for hospice care in 2023. Stakeholders in this area claim to have used pre-pandemic data to calculate rates that do not take into account rampant inflation and other swelling costs.
North Carolina-based home health and hospice provider 3HC may reconsider launching a palliative care program with reduced payments, according to CEO Dean Lee.
“Our hospice has grown significantly. We continue to emphasize that because we know there are many unmet needs on the hospice side,” Lee told Hospice News. .. “We were fortunate to be able to bridge people [from home health to hospice] Most are needed without a formal palliative care program, but there is a need for them as some people fall into the gap. “
The palliative care program planned by 3HC has encountered a number of obstacles since the organization began consideration.
Nonprofits began moving to palliative care shortly before the pandemic, but had to postpone the launch due to lack of access to patients, primarily facility-based, Lee said. Did. When the proposed payment cut news hit, 3HC was resuming program development.
“We are trying to start it again, and we see further cuts, which means that our mitigation program will continue to be put on hold,” Lee said. “At this point, no funds have been invested due to margin pressure.”
