Medicare Home Health Beneficiary Population is Older, Poorer, Sicker and More Likely to be Women and Minorities than All Other Medicare Beneficiaries

March 3, 2014
Contact: Emily White

Medicare Home Health Beneficiary Population is Older, Poorer, Sicker and More Likely to be Women and Minorities than All Other Medicare Beneficiaries

Data analyses underscore that deep Medicare cuts to home health impact a population that is disproportionately vulnerable and female

WASHINGTON – New analyses completed by Avalere Health and Dobson DaVanzo & Associates released today by the Partnership for Quality Home Healthcare find that the majority of Medicare home health beneficiaries and caregivers, both skilled and informal, are women and that Medicare home health beneficiaries are among the most vulnerable of all Medicare beneficiaries.

The newly-released data show more than 60 percent of Medicare home health beneficiaries are women. An estimated 90 percent of registered nurses, occupational therapists, and home health aides – professionals that are commonly employed by home health agencies – are women, as well. Avalere Health analysis also reveals that the Medicare beneficiaries who receive home health services are older, poorer, sicker and more likely to be minorities than the rest of the Medicare beneficiary population.

“These data underscore that the deep cut to Medicare home health resulting from the Affordable Care Act poses a disproportionate risk to women and vulnerable seniors,” stated Eric Berger, CEO of the Partnership. “According to Administration estimates, ‘approximately 40 percent’ of all home health agencies will experience net losses as a result of the Affordable Care Act (ACA) home health cut. As demonstrated by these data, the cut’s impact will be most felt by the women – who primarily staff home health agencies – and the vulnerable, female and minority patients they serve.”

The Medicare home health benefit on which 3.5 million seniors depend is being subjected to a 14 percent cut in funding, due to the imposition of a four-year, 3.5 percent per year rebasing adjustment implemented by the Obama Administration on January 1 using discretionary authority granted by the Affordable Care Act. According to the Administration, the ACA cut will cause “approximately 40 percent” of all home health providers to operate at a loss by 2017. The cut was opposed by seniors advocates, hospitals, home health and other providers, and small business experts due to the threat it poses to low-cost, high quality home healthcare.

The data released today demonstrates that Medicare home health beneficiaries are older, sicker, poorer, are more likely to be female, are more likely to be members of ethnic or racial minority populations, and have greater functional limitations, disabling conditions, and greater difficulty completing routine tasks than all other beneficiaries in the Medicare program. A summary of the findings is below:

Avalere Home Health Beneficiary Study: Key FindingsMedicare Home Health BeneficiariesAll Other Medicare Beneficiaries
Beneficiaries aged 85+24.4%12.1%
Beneficiaries with 4+ chronic conditions74.7%48.5%
Beneficiaries needing assistance with 2+ Activities of Daily Living (ADLs)23.5%7.6%
Beneficiaries at or below 200% of Federal Poverty Level (FPL)66.2%47.9%
Beneficiaries from ethnic or racial minority population19.3%14.9%
Dual-eligible Medicare-Medicaid beneficiaries26.7%17.7%
“Without continued access to high-quality, clinically-effective care provided in the Medicare program’s lowest-cost setting – the home – many of these vulnerable patients will have no other choice but to obtain the care they need in more expensive institutional care settings. As a result, we call on lawmakers to protect these vulnerable patients from the further harm that would result from any additional cuts to the Medicare home health benefit and, instead, join our community in urging the Administration to moderate the deep ACA cut recently imposed on these seniors,” added Berger.

Additionally, as this newly imposed cut will drive 40 percent of home health providers to net losses in the next four years, many agencies will be forced to close their doors or make significant staffing reductions, putting at risk an estimated 498,159 jobs. Due to the make-up of the workforce, the large majority of these job losses will affect women.

In conducting this analysis, Avalere Health used the 2011 Medicare Current Beneficiary Survey (MCBS) Access to Care File, a national representative survey of the Medicare population, as well as data from the Bureau of Labor Statistics and HRSA.

Medicare Beneficiary Analysis >>

Medicare Beneficiary and Workforce Analysis >>

Vulnerable Patient Population Issue Brief >>

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