Proposed payment rules for other settings Predict health issues at home

Home healthcare operators are still weeks away from getting a preview of the proposed payment rule for 2023. Even so, they’re starting to see signs of concern that they won’t get an adjusted rate. to inflation.

Due to investments in labor, more expensive supplies, and the overall increase in the cost of goods and services in the United States, including the price of gasoline, it has become more expensive for agencies home health to stay in business.

As a result, the U.S. Centers for Medicare & Medicaid Services (CMS) should factor it into its annual rate update, advocates say.

“Rising gas prices are a problem for home health care and hospice providers, and expenses for labor, supplies, and other goods and services are a concern for care providers. as well as palliative care, nursing homes and other service settings,” Mollie Gurian, vice president of home policy and HCBS at LeadingAge, told Home Health Care News in an email. “Members of the nonprofit and mission-driven home health care at LeadingAge tell us they are concerned about the rising cost of gas and staff – and they would like to see these price increases recognized in the annual update.”

Gurian isn’t the only one feeling this.

While CMS updates home health rates by an inflation index every year, updates have not kept pace with rising costs for staff, medical supplies and fuel, Joanne said. E. Cunningham, executive director of the Partnership for Quality Home Healthcare. HHCN.

“The Partnership presented data from our survey to CMS last year on the significant cost increases facing providers and urged CMS to better reflect this in Medicare payments to home health agencies,” said she said in an email. “This year, we continue to advocate for policy changes to help address these higher costs.”

First signals

Each year, CMS publishes its proposed payment rule for home health – relating to changes in procedure, conditions of participation (CoP), payment rates and policies, among others – for the following year. CMS, generally, publishes it before July 1st.

Although the proposed payment rule for home health has yet to be released, industry stakeholders have already begun to forecast what providers can expect to see in terms of the Medicare payment landscape. .

And with these stakeholder predictions of what to expect, proposed changes in other sectors may be a sign of what’s to come.

On the palliative care side, CMS recently proposed a 2.7% salary increase for 2023. of the impact of the COVID-19 emergency and ongoing inflation.

CMS also proposed a 2.7% Medicare rate for inpatient psychiatric facilities (IPF).

Meanwhile, operators of skilled nursing (SNF) facilities have seen a proposal to adjust SNF payment rates downward by 4.6%, in part to balance the patient-focused payment model ( PDPM). SNF advocates have strongly criticized the potential cuts, pointing out that it could deepen the financial crisis that nursing homes were already experiencing.

If these proposed changes for hospices, SNFs and IPFs are any sign of what’s to come for home health, it could spell trouble for providers.

William A. Dombi, president of the National Association for Home Care & Hospice (NAHC), also noted that providers could see a proposed massive regulatory cut in home health care.

“On the home health front, this is absolutely an important time to look at what’s happening,” NAHC’s Dombi said during a panel discussion last month at HHCN’s Capital + Strategy conference. “We are looking at the likelihood that CMS will undertake its efforts to examine budget neutrality for the move to PDGM (Patient-Driven Groupings Model).”

Gas prices and inflation affect household health

Inflation in the United States hit 8.5% last month, its highest level since December 1981, the US Department of Labor said in its monthly consumer price index report.

Gasoline prices, in particular, jumped 18.3%.

Most of the United States is feeling the impact of inflation and gas prices, including those in the far-flung home healthcare industry.

On average, caregivers see several clients daily. They travel up to 10 miles and 30 minutes to 45 minutes from each customer. This equates to an additional cost of $1 per hour for workers who typically earn $10 to $13 per hour, according to NAHC data.

In today’s economy, all those trips add up quickly.

“If you’re making $10 to $13 an hour and the cost of traveling three to four tours a day is one hour for every 10 miles traveled, that takes away a lot of your earning power,” David Totaro, chief government affairs officer of Bayada Home Health Care, told HHCN. “We are starting to have a lot of [caregivers] telling us they can’t take referrals or clients who are away between home visits. This particularly affects rural areas.

In addition to his role at Bayada, Totaro is also a member of the NAHC Board of Directors.

For suppliers, these conditions strain their ability to sustain this business, according to Totaro.

While there have been state and federal actions on this front, he believes more needs to be done.

“We are seeing efforts by state governments and the federal government to intervene,” Totaro said. “Many states are considering waiving the state gasoline tax. Congressman Donald Norcross has called for the federal gas tax to be suspended, but even those solutions are short-term. This is no way to sustain a long-term business. The only way to do this is to raise caregiver salaries to a point where they can be competitive with other industries.