Congress should protect access to home health care

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Throughout the pandemic, Minnesota's home health care agencies and clinicians have had to navigate a series of setbacks and challenges that have made it more difficult to meet the increased demand for in-home care. Those challenges, including rising labor and still-high fuel costs, as well as record inflation, have worsened an already notable workforce crisis within the home health community, leaving an increasing number of at-risk patients without care.

Now, even as the home health sector continues to struggle with these factors, proposed Medicare cuts are threatening to pull the rug out from under home health providers in Minnesota and throughout the country. The impact would be detrimental to the entire home health care community — especially the nearly 33,000 Medicare beneficiaries annually across Minnesota who depend on home health.

Despite the enormous value home health offers to patients and families, Medicare is considering a roughly 8% permanent cut to home health care services. On top of that, Medicare is pushing for another $3 billion in cuts that would be imposed as a "clawback" for services provided since the onset of the pandemic — from 2020 through this year. Nationally, these cuts would slash billions from home health care in 2023 alone — including more than $37 million here in Minnesota.

These cuts would have a significant, negative impact on the home health care community's ability to care for the influx of new patients being referred to home health. Since March 2020, growing demand for these services has led to a 33% increase in referrals for home health; however, over that same time period, actual home health admission rates declined by 15% due the staffing challenges and labor cost pressures already impacting the sector. Three home health agencies in Minnesota have closed this year alone due to staffing shortages, and the proposed cuts would exacerbate this trend.

Additional cuts on top of all this will only undermine access to the home-based care services patients and their families prefer. That includes some of the most medically vulnerable, at-risk patient groups in our state. Nearly 92% of our state's Medicare home health beneficiaries live with at least three chronic health care conditions, compared with just 18% of Minnesota's Medicare beneficiaries overall. Home health services play an important role in the delivery of health care to patients who are quite simply safer, not to mention more comfortable, at home.

There is a chance these harmful cuts could be avoided, or at least delayed, but it requires Congress to act quickly. Fortunately, lawmakers in both the House and Senate have introduced legislation to address these cuts before they can do real harm. For the sake of Minnesota's home health providers and patients alike, lawmakers in Minnesota's congressional delegation should support and help pass the Preserving Access to Home Health Act of 2022.

If passed, this bipartisan legislation would block the $3 billion in "clawback" cuts set to begin as soon as 2024 and delay the proposed nearly 8% permanent cut to home health services until at least 2026. This would hopefully give Medicare enough time to review and readjust its approach to budget neutrality in a way that does not impact quality or access to care for millions of older and disabled Americans — the vast majority of whom prefer this kind of personalized, compassionate care.

In fact, a recent survey confirmed what many in the home health community already knew: Home health services are exceedingly popular — not just among patients, but with voters as well. According to survey results, 91% of seniors would prefer to receive care in their own home, while 97% of Medicare beneficiaries believe the federal government should maintain Medicare coverage for at-home health care — something that 92% of voters overall agree with as well.

Moreover, according to the survey, 78% of voters think it is important for Congress to pass legislation opposing proposed cuts to Medicare home health services, including 88% of Medicare beneficiaries and voters ages 65 and older. Our members of Congress should keep this in mind as the critical midterm elections approach, and work together to pass legislation protecting and preserving access to home health care.

Kathy Messerli is the executive director for the Minnesota Home Care Association. She has held positions with Minnesota long-term care and medical associations and the National Multiple Sclerosis Society, Minnesota Chapter.