The Medicare Payment Advisory Commission recommended that Congress reduce the payments for Home Health by 7% in 2021. In other healthcare sectors, the recommendations were the following.

MedPAC, the commission that reports to Congress on Medicare recommends in 2021 the following:

  • The Health and Human Services Secretary increase the fiscal year 2020 Medicare base payment rates for long-term care hospitals by 2% in 2021;
  • Congress reduce the FY 2020 Medicare base payment rate for inpatient rehabilitation facilities by 5% in 2021;
  • Congress eliminate the FY 2021 update to the Medicare payment rates for skilled nursing facilities;
  • Congress increase the calendar year 2021 Medicare payment rates for physician and other health professional services by the amount specified in current law;
  • Congress reduce the CY 2020 Medicare base payment rate for home health agencies by 7% in 2021;
  • Congress eliminate the CY 2021 update to the Medicare conversion factor for ambulatory surgical centers, and HHS require ASCs to report cost data;
  • Congress eliminate the FY 2021 update to Medicare base payment rates for hospice providers; and
  • Congress increase the calendar year 2021 Medicare end-stage renal disease prospective payment system base rate by the amount specified in current law.

Market Overview

Home Health Industry Overview, 2018

  • $17.9 billion total Medicare Expenditures
  • Over 11,500 agencies
  • 6.3 million episodes for 3.4 million FFS Medicare beneficiaries

Medicare Payment and Home Health Agency Costs

  • 15.3 percent Medicare margins in 2018
  • Projected margin estimated to increase in 2020 to 17 percent

Hospice Overview 2018

Hospice use:

  • Over 1.5 million beneficiaries
  • Over 50% of decedents
  • Over 4,600 providers
  • $19.2 billion in Medicare payments to hospice providers

Hospice Costs and Medicare Payments

  • 2017 Medicare margin: 12.6%
  • 2020 projected margin 12.6%

For more resources on home health, see https://remingtonreport.com/intelligence-resources/post-acute/

For more resources on hospice, see https://remingtonreport.com/intelligence-resources/hospice-palliative-care/