When the Centers for Medicare & Medicaid Services (CMS) finalized the Home Health Prospective Payment System (HHPPS) Rule for CY 2018, the home health community was pleased to see that the Home Health Groupings Model was not included in the final rule.

This was a huge relief for the three and a half million seniors who rely on home health services every year, whose care would have been at risk under this new rule.

Here at the Partnership, we are thankful that leaders at CMS and in the Administration listened to the concerns of theircolleagues in Congress and stakeholders throughout the home health community. And we are also thankful to you, our home health advocates!

Since the HHGM rule was proposed, you made sure that your voices were heard. Collectively, you sent more than 40,000 emails to Members of Congress.  With your help, we also secured publication of nearly 30 letters-to-the-editor across the country.

As a result of your efforts, more than230 bipartisan lawmakers joined with us in urging CMS to not finalize HHGM and instead work with home health stakeholders on policy solutions that preserve access to quality cares services in the home.

We want to thank you for your hard work to protect seniors’ access to care, and encourage you to share a message of thanks with the lawmakers who stood with us on this issue. You can take action by clicking the button below:

Our concerns about the Home Health Groupings Model (HHGM) proposed by the Centers for Medicare & Medicaid Services (CMS) are being echoed by patient advocates, provider groups and bipartisan lawmakers!

Groups ranging from the American Hospital Association to a group of 49 bipartisan members of the Senate have called the proposal “drastic” or “radical” and have pointed out that HHGM will “create major incentives to underserve Medicare beneficiaries.” Below are some examples of what these  groups are saying about HHGM:

“HHGM methodology only reflects the needs of some Medicare beneficiaries, while Medicare law applies to every Medicare beneficiary.”

“A change of this magnitude is also likely to put patient access at risk for Medicare beneficiaries in rural and smaller communities with few HHAs and America’s Veterans who largely depend on home health.” 

“We have heard from a number of stakeholders who are concerned that the proposed rule lacks sufficient information and data points to allow home health agencies to accurately estimate the impact of the proposed HHGM.”

Now, it is your turn to share concerns about HHGM with your local papers and Members of Congress!

It’s essential that every Member of Congress hear from the home health community on this important issue.

As a person gets older, certain things once taken for granted become increasingly difficult. Health becomes harder to manage and appointments with doctors and healthcare providers become harder to reach, especially for seniors residing in rural areas.

The Moran Company estimates the average rural patient’s travel distance to her doctor or nearest hospital is about double that of her city counterparts. Many older Americans are unable to travel such long distances, leaving them with no option but to depend on home healthcare services to ensure their wellbeing.

With that distance comes expense, and elderly patients using home health are left with significantly higher medical costs. In 2000, Congress began to combat this price differential through Medicare’s implementation of a rural safeguard. The safeguard protects older patients with poor health in rural areas who depend on home healthcare services by covering the higher costs of travel and staffing.

This safeguard has protected older Americans for 17 years, but is now set to expire on Dec. 31, 2017. On the eve of the safeguard’s expiration, we must remember how important it is to not let rural locations hinder any American’s chance at maintaining good health.

This issue is crucial to our nation’s rural seniors, and it’s critical that we communicate its value to lawmakers in Congress to ensure it is extended.

Urging your lawmaker to support the rural safeguard extension is simple. Write a letter to your lawmaker or ask for their support in your local newspaper by visiting our

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 Medicare 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<.

This week, a bipartisan group of Florida lawmakers sent a letter to Health and Human Services Secretary Tom Price, MD urging him to reject the Medicare Home Health Pre-Claim Review Demonstration and replace it with a more effective program to tackle Medicaid fraud.

The letter, which was signed by twenty-seven members of Florida’s Congressional delegation, including Senators Bill Nelson (D) and Marco Rubio (R), called on CMS to put the breaks on PCRD ahead of its scheduled implementation date on April 1^st. The program was first rolled out in Illinois last August and resulted in numerous technical issues and improper care denials across the state. Because of these issues, CMS initially delayed PCRD from taking effect in Florida and several other states for many months in order for it to be improved. However, it is clear that no serious effort was made to fix the underlying problems with PCRD during that time.

“We support efforts to combat Medicare fraud and protect taxpayer funds, but we are concerned that the PCRD’s current parameters are too broad to reduce fraud and improper payment rates,” the letter reads. “We encourage you to consider an alternative approach that would achieve these goals and ease the administrative burden and additional implementation costs for smaller home health agencies, and ensure timely patient access to services.”

The letter also raises the concern that Pre-Claim Review imposes onerous restricts on small home health providers, and was implemented without going through the formal rulemaking process.

You can read the full letter here.