Association News

FOR IMMEDIATE RELEASE --- July 27, 2022

Media Contact: Adrian Dipple 919-848-3450 ext. 110, [email protected]

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“Proposed federal regulatory change would devastate North Carolina home health agencies; patients would suffer.” AHHC of NC Responds to Home Health Prospective Payment System (“HHPPS”) Proposed Rule and Federal Legislation Introduced to Pause Payment Cuts

RALEIGH, NC, JULY 13, 2022 – The Association for Home & Hospice Care of North Carolina (AHHC of NC) expresses disappointment and frustration with the Centers for Medicare & Medicaid Services’ (CMS) Home Health Prospective Payment System (“HHPPS”) Proposed Rule for Calendar Year (CY) 2023, released on June 17, 2022 and published in the federal register on June 23, 2022. Within the HHPPS Proposed Rule, CMS recommends an unprecedented, permanent 7.69% rate cut to home healthcare services. AHHC welcomes recently introduced legislation that would stall these drastic cuts.

The proposed rate reduction of 7.69%, which CMS attributes to “behavioral adjustments,” is predicted to result in a 6.9% reduction in total payments, nationwide. Along with the proposed payment cut, CMS offered a small increase of 2.9% attributed to inflation and an estimated 0.2% decrease due to a proposed update to the fixeddollar loss ratio (FDL) used in determining outlier payments. These adjustments result in a net cut of 4.2% in 2023, equaling an $810 million cut starting January 1, 2023. Based on this flawed methodology, CMS projects more cuts in the years to come. The National Association for Home Care & Hospice (NAHC) and the Partnership for Quality Home Healthcare (PQHH) have previously cited flaws in the methodology used for calculating home health payment adjustments and recommended detailed technical changes to the methodology. AHHC of NC is disheartened CMS did not take those recommendations into account. For these reasons, AHHC of NC along with many other home health associations and agencies in North Carolina and nationally strongly oppose the payment modifications recommended in the HHPPS Proposed Rule.

Tim Rogers, President and CEO of AHHC of NC, stated: “Not in my 31 years’ experience serving this industry have I witnessed such a potentially, devastating CMS action toward North Carolina and home health nationally. The severe payment cuts proposed by CMS would drastically reduce access to quality home health services for North Carolinians, particularly for rural and medically underserved patients.” Already impacted by severe staffing shortages, North Carolina’s 215 home health agencies service several hundred thousand Medicare patients and other patients in North Carolina. Rogers continues: “This nation should be celebrating and supporting our Medicare beneficiaries, not imposing policies that will severely impact their ability to receive health care and remain in their own home.”

Since the release of the HHPPS Proposed Rule, AHHC of NC has been examining and evaluating its effect on the home health industry. AHHC of NC has worked closely with its national partners, PQHH and NAHC, to analyze and understand fully the consequences of CMS’s HHPPS Propose Rule on North Carolina home health agencies. With its national partners, AHHC of NC continues to communicate with federal leaders on how to address these critical issues.

“Care in the home is the safer and by far, the preferred choice for North Carolina seniors and people with disabilities. Polling shows an overwhelming preference for care in the home: 94% of Medicare beneficiaries say they would prefer to receive posthospital care at home. This proposed rate cut would create a high degree of instability among home health providers, threatening our direct care workforce during a time of ongoing volatility caused by the current COVD-19 pandemic,” Rogers said.

On July 25, 2022, U.S. Senators Debbie Stabenow (D-MI) and Susan Collins (R-ME) introduced bipartisan legislation, The Preserving Access to Home Health Act of 2022, S 4605, to prevent these proposed cuts to home health payment rates from taking effect prior to 2026. The legislation would ensure any determined necessary adjustments are made by 2032, allowing more time for CMS to refine its proposed approach to determining budget neutrality in home health.

AHHC of NC is grateful to long-time home health care champions Senators Stabenow and Collins for their efforts and attention to this imperative issue. Home health providers continue to face extraordinary challenges such as drastically increasing gas prices, record inflation, ongoing unpredictable pandemic expenses, and a workforce crisis. Making deep and unnecessary cuts to payments would only exacerbate insecurity for home health agencies, its workforce, and the North Carolinians they serve.

In addition to supporting The Preserving Access to Home Health Act of 2022, S 4605, AHHC of NC continues to review the HHPPS Proposed Rule and will be submitting formal comments to CMS before the close of the official comment period on August 16, 2022.

The Association for Home & Hospice Care of North Carolina (AHHC) is a nonprofit trade association representing providers of home health, hospice, palliative care, personal care, private duty nursing and companion/sitter services. The Association was established in 1972is one of the oldest and largest state associations and currently has a membership of over 750 provider agencies (including representation of 98% of all home health agencies in North Carolina) and vendors, who provide products and services to providers. AHHC's mission is to provide Resources, Education, Advocacy and Leadership. Services include: technical assistance, monthly newsletters, quality educational programs, annual directory, email alerts, and political lobbying. AHHC strongly advocates for their members and the many patients they serve, and is recognized by colleagues, regulators, and legislators as one of the most active and effective home care and hospice associations in the US.

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