A survey conducted by NAHC in early April of home health agencies showed that this pandemic has severely damaged the health care delivery system. Respondents to the survey totaled 1119 and included home health companies from all states. Of the respondents, 67.3 percent provide some care in rural areas. The results show serious concerns about the financial stability of home health agencies as operations and revenues have been severely affected in multiple ways.

Nationwide, 41.5 percent of HHAs report serving actively infected COVID-19 patients. In the “hot spot” of New York/New Jersey, 85.71 percent of HHAs report serving such patients.

“Here is a summary of their findings:

  • 85 percent of respondents report revenue reductions with a median reduction between 15 and 20 percent.
    • 7 percent report revenue reductions in excess of 20 percent
    • 53 percent report revenue reductions in excess of 15 percent
    • “hot spots” such as New York and New Jersey report even higher reductions, with the NY/NJ region indicating 67.9 percent with greater than 15 percent revenue reduction and 46.3 percent reporting greater than 20 percent revenue reduction
  • Revenue reductions are primarily related to two factors: decreases in new patient admissions and patient refusal to accept all physician-ordered care to avoid virus transmission risks.
    • 79 percent report decreases in admissions with 56 percent indicating reductions greater than 15 percent and 37.3 percent reporting reductions in excess of 20 percent
    • “hot spot” locations report much higher losses of new patients with 92.8 percent of HHAs in NY/NJ reporting decreases and 75 percent indicating a decrease of 15 percent or greater and 57.1 percent indicating a decrease of greater than 20 percent
    • Nine percent of HHAs report patients’ refusals of care
  • Refusals of all physician-ordered care have triggered payment reductions through the Low Utilization Payment Adjustment (“LUPA”). LUPA rates reduce average reimbursement by approximately 75 percent or $1500 over a 30-day period.
    • 52 percent of HHAs with below national average LUPAs in March 2019 report at least a tripling of LUPAs in March 2020
    • 67 percent of all HHAs report at least a doubling of LUPAs
  • The revenue and care demand reductions have cost HHA employee’s jobs.
    • 54 percent of HHAs report reductions in clinical staff
    • 8 percent report reductions in administrative staff
  • Respondents indicate that the top three concerns about their future are:
    • Significantly reduced revenues
    • Patient safety with inadequate supply of Personal Protective Equipment (PPE)
    • The inability to fully utilize telehealth services as an adjunct to in-person care that is reimbursed by Medicare”

Source: NAHC Report


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