New Study Shows Why We Need to Expand the Home Health Rural Safeguard

A new study by the Moran Company uncovered the many challenges home health beneficiaries in rural areas face in accessing care.

The study found significant disparities between rural and urban home health beneficiaries:

  • In 2014, seniors living in rural areas were 15% less likely to receive home health services.
  • Medicare home health beneficiaries in rural areas are older, have a lower income, and live with more chronic conditions than the general Medicare population.
  • Medicare home health beneficiaries in rural areas are 17% more likely to be below 200 percent of the federal poverty line.
  • Rural Medicar patients live twice as far from their doctor compared to beneficiaries in urban areas.

Another factor compounding these disparities is the high cost of providing home health services to patients living in rural communities. According to a study by Ability, the cost of providing Medicare home health services is 36% higher per parent episode in rural areas than in urban areas – mainly due to the long distances providers must travel to reach patients in their homes. This presents a challenge for providers, who ultimately bare the higher cost of delivery.

Historically, the Congress has rightly understood these challenges and since 2000 has provided safeguard “add-on” payment to the reimbursement rate for Medicare home health services delivered in rural areas. This “rural safeguard” covers those extra costs so beneficiaries in rural areas have their home health needs met.

Unfortunately, the safeguard is set to expire at the end of this year, which is why home health providers are urging Congress to renew the program before time runs out. In the coming months, the Partnership will work diligently with lawmakers, patients, and stakeholders to ensure that home healthcare remains accessible to older Americans living in rural areas.

To learn more about Medicare’s rural home health population, click here.

Good News: CMS is Re-thinking the Home Health Pre-Claim Review Demonstration

On March 31, the home health community received some good news from the Centers for Medicare & Medicaid Services (CMS)!

CMS announced that it would stop the planned implementation of a Pre-Claim Review Demonstration (PCRD) in Florida, which would have applied new, mandatory regulatory requirements on all home health agencies operating across the state on April 1 and pause the PCRD program currently underway in Illinois for at least 30 days, which has made the delivery of timely home healthcare difficult since implemented in August 2016.

Here at the Partnership, we are incredibly grateful CMS responded to the concerns expressed by bipartisan lawmakers, home health providers, and advocates both in these states and across the country. We also want to applaud the thousands of advocates who collectively reached out to CMS and their lawmakers in recent months – your efforts truly made a difference!

We hope this decision will allow the home health community to work with CMS to strengthen the Medicare home health program by developing policy alternatives and through proper education and training. We welcome the opportunity to work with CMS to develop alternative, targeted reforms to reducing fraud and abuse without disrupting the care for our vulnerable Medicare patients.