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 president and publisher of the Remington Report magazine and President of Remington’s Home Care Leadership Think Tank. She has worked with more than 10,000 organizations in both a consultancy role and an educator. Lisa monitors the complex key trends and forces of change to develop a correct strategic approach to de-risk decision-making and create sustainable futures across the healthcare continuum.