Patients are receiving less access to Medicare-certified home health care in recent years, according to a new data analysis.
The data analysis – which comes from the Partnership for Quality Home Healthcare (PQHH) and CareJourney by Arcadia – examines Medicare home health fee-for-service claims from 2022 through 2023, in order to determine access to care, and how it has been impacted by payment rate cuts.
An analysis of 2022 data found that almost 35% of patients who leave the hospital, and receive a home health discharge, don’t access this care within a seven-day period.
Additionally, the findings show that patients who didn’t receive home health care had a death rate that was 41% higher than patients who accessed this care in a timely manner.
“There’s abundant data from all over the place about what kind of impact home health care has on a patient’s outcomes, their ability to stay out of the hospital, readmission rates, all of those things,” PQHH CEO Joanne Cunningham told Home Health Care News. “This was yet another confirming data point that actually looked at mortality rates. I found that very interesting, and not surprising at all for the home health provider community.”
The analysis also found that, in 2023, access to home health care led to a 34% decrease in hospital readmission rates. Despite this benefit, 35.7% of Medicare patients that were directed to receive this care after a hospitalization did not.
Plus, the home health referral rejection rate has seen a major increase, jumping from 49% in 2020 to 71% in 2022.
Broadly, the referral rejection rate tracks how often providers turn down new referrals, generally due to staffing or capacity constraints.
One of the main takeaways from the analysis was that these access-to-care issues are related to cuts made to home health care’s base rate in recent years.
“We think it points to an emerging crisis in the Medicare home health program,” Cunningham said. “Unless it is addressed by Congress, with the legislation we’re pushing for, and CMS with the cuts that are on the table through the rulemaking system, you’re going to see the home health care program just disappear over time.”
The latest home health proposed payment rule includes a payment decrease in the aggregate by 1.7%, or by about $280 million.
Cunningham emphasized the need for stability in the payment structure.
“One of the ways that Congress can address this is by ending CMS’ authority to make any more cuts to the home health care program,” she said. “It would allow for agencies to get on some more stable footing.”
Ultimately, Cunningham believes the results of the data analysis shouldn’t come as a surprise for those watching closely.
“This is what you get after you see sustained, destabilizing, repeated cuts to a program that is a really important program to America’s seniors and disabled community,” she said.
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