MedPac released its latest report on Friday, March 13th. The recommendations for home health and hospice are the same as previous years, which includes:
- Recommendation for a per episode copay for home health episodes that are not preceded by hospitalization or post-acute care use.
- Revision of the home health case-mix weight to no longer use the number of therapy visits as a payment factor but to instead rely on patient characteristics to set payment for therapy and non-therapy services.
- Begin a two-year rebasing of home health rates and eliminate the market basket update.
- Eliminate the update to the hospice payment rates for fiscal year 2016.
The report also contained new data for both the home health and hospice industries.
Home Health
The number of home health agencies increased in 2013 by 302 agencies to a total of 12,613. There were almost 1,700 more agencies in 2013 than in 1997 and almost all the new agencies are for-profits.
The number of home health episodes declined by 2% from 2011 to 2013. MedPac sites several reason for the decline, which include:
- increased program integrity investigations
- implementation of the face-to-face documentation policy
- reduction in hospitalizations
Although hospitalization rates were not provided for 2013, MedPac reiterated that non-profit agencies have a lower hospitalization rate than for-profit agencies.
Hospice
Use of hospice services increased in 2013 among Medicare beneficiaries. Almost half (47.3%) of eligible Medicare beneficiaries elected hospice services. In 2013, 3,925 hospice provided care to Medicare beneficiaries, which is a 5.3% increase from 2012. The number of for-profit hospices increased while non-profit hospices decreased slightly from 1,318 in 2012 to 1,314 in 2013.
MedPac anticipates that since the Affordable Care Act mandated quality reporting, reporting of the quality of hospice care is expected to be available in 2017 at the earliest.
MedPac estimates that because of upcoming changes to hospice payment rates, the 2015 aggregate margin will be 6.6%, which would be a decrease from 10.1% in 2012.