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/
Lisa Remington is widely recognized as one of the foremost futurists in the home care industry, focusing on healthcare trends and disruptive innovation. She serves as the president and publisher of the Remington Report magazine and is also the President of Remington’s Think Tank Strategy Institute. Lisa provides strategic advice and education to over 10,000 organizations, assisting them in developing transformative strategies for growth and their future implications. She closely monitors complex trends and forces of change to develop effective strategic approaches.
