(Alexandria, VA)- The National Alliance for Care at Home (the Alliance) today responded to the Centers for Medicare & Medicaid Services’ (CMS) Calendar Year (CY) 2027 Home Health Prospective Payment System Proposed rule. CMS proposes an overall increase of 2.4% or $420 million in payments to home health agencies for 2027, a positive step made possible in part by the Alliance’s ongoing advocacy for the sustainability of the home health benefit. However, the application of a 3.0% temporary adjustment continues to be of concern and could jeopardize access to care in the home.
The Alliance acknowledges and appreciates the headway made with CMS in understanding the true cost of delivering home health care and the value it provides to the millions of Americans who depend on it. However, the Alliance emphasizes that Medicare payment rates – with the 3% temporary adjustment applied – still do not align with the actual cost of providing comprehensive, high-quality care. In a recent letter to CMS, the Alliance encouraged CMS to eliminate all permanent and temporary adjustments due to problems in the data and analyses used to calculate payment rates.
“While the proposed rate update results in increased payments relative to last year – a reflection of our continued advocacy and a much-needed reprieve for providers under the stress of increasing costs – the Alliance remains focused on working to stop unwarranted temporary adjustments that are based on a flawed methodology with underlying data integrity issues,” said Jennifer Sheets, CEO of the Alliance. “We will continue to partner with CMS on policies that strengthen the Medicare home health benefit. Ultimately, federal policy must preserve patient access to care at home, which remains the preferred choice of care for millions of families.”
The Alliance also appreciates CMS’s interest in considering the role palliative care plays in the Medicare home health benefit. Medicare home health services are interdisciplinary in nature and often focus on relieving symptoms, managing pain, improving comfort, and supporting quality of life for individuals with serious or chronic illnesses while they continue to receive medical care at home. A substantial proportion of seriously-ill individuals utilize home health services during the last year of life, and recognizing the role of home health care in providing palliative services through future updates to CMS’s sub-regulatory guidance could help clarify coverage and ultimately increase patient access to needed services under this important benefit.
The Alliance is reviewing several other proposals in the rule that will shape home health operations in the year ahead. CMS is soliciting comment through a Request for Information on developing a home health-specific wage index, a structural change that warrants careful study to ensure it reflects the true cost of delivering care. The rule also proposes updates to Home Health Quality Reporting Program submission deadlines and a shift to calendar-year OASIS and HHCAHPS reporting, along with new provider enrollment and revocation authorities intended to strengthen program integrity. The Alliance supports reasonable, targeted efforts to root out fraud, waste, and abuse, but will scrutinize whether these enforcement tools are applied fairly and do not create new burdens for legitimate providers.
It is crucial that CMS, Congress, and the home health community continue working collaboratively to enact lasting protections to ensure home health remains available for Medicare beneficiaries and their families, both now and in the future. The overwhelming majority of American voters believe it’s important that home health services be available, and the Alliance remains committed to supporting policies that strengthen access to home health.
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About the National Alliance for Care at Home
The National Alliance for Care at Home (the Alliance) is the leading authority in advancing care in the home. We envision an America where everyone has access to the highest quality, person-centered healthcare wherever they call home. Through advocacy, education, and convening, we connect providers and stakeholders to strengthen care delivery across the home-based care continuum — spanning home care, home health, hospice, palliative care, and Medicaid home and community-based services. Learn more at www.AllianceForCareAtHome.org.
Press Contact
communications@allianceforcareathome.org
Hannah Kristan | 202-355-1647