Posted Friday, September 15, 2023
Earlier this month, Home Health Care News hosted its annual FUTURE and during it home care providers shared their frustrations. The focus of their frustrations was clearly the current payment environment. Throughout the week home health providers really honed in on three top-of-mind topics, the first being those MA plan relationships. The others: CMS proposed payment rule and the state of staffing.
Amedisys Inc. Chief Strategy Officer Nick Muscato and VitalCaring CEO April Anthony said that some MA plans had not updated their home health payment rates for as many as five years.
Anthony directed her grievances at this fact. “It’s frustrating to see where Medicare is going with their rates, and what they’re trying to do with clawbacks,” Anthony said. “But, if one of our managed care partners came to us with those [traditional Medicare] rates, we would be jumping for joy. We’d be saying, ‘This is the greatest contract we could possibly hope for.’”
CMS is paying MA plans. They’ve also unintentionally subsidized those plans in the home health arena, allowing them to offer subpar rates while traditional Medicare keeps providers’ heads above water. Now that the agency has decided to cut rates, though, those providers are beginning to sink.
Every home health provider in the country would like higher fee-for-service rates from CMS. But not everyone is willing to fight for it, Healing Hands Healthcare CEO Summer Napier said at FUTURE. During a breakout session, Napier found that no one in the room had given CMS comments about the new payment rule when they asked for them. If providers do not use their voices now, then when?
Home health agencies cannot staff every case they’re being referred right now, and this is a constant problem for all as of late. They must use their clinical capacity accordingly.
Providers have said that they’ve begun to prioritize certain patients based on the referral relationship or payer source behind that patient. Ultimately, though, they don’t want to have to pick and choose between patients at all. Reimbursement is one way to help with staffing. More reimbursement means higher wages for workers.
“What this type of employment offers is oftentimes misunderstood,” Jeff Marsh, the chief growth officer of Compassus, said at FUTURE. “But we’re all competing for the same finite nursing resource. So, the one that becomes that employer of choice is the one that wins.”
Source: Home Health Care News
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