Federal Threats to Home Health and Hospice Access for Vermonters

The holiday season provides us with an important opportunity to reflect, and to give gratitude for the home health and hospice workers who allow us to be with our loved ones in their homes during this special time.

Home health and hospice workers around Vermont care for our family members, friends, and neighbors at a time when their need for comfort is at its greatest.

Vermont is one of the oldest states in the country. It is also a state where we believe strongly in supporting the care and independence of older Vermonters.

Unfortunately, home health and hospice services are both being threatened by shortsighted federal policy.

A finalized 7.85% cut to Medicare home health rates by the Center for Medicare and Medicaid Services (CMS) will make it harder than ever for Vermont home health and hospice providers to care for our friends and neighbors.

This permanent cut is contained within the 2023 Home Health Prospective Payment System (HHPPS) Final Rule. In acknowledgement of the significant hardship this massive cut will create for providers, CMS has decided to phase in half of the reduction – 3.925% – for Calendar Year 2023. However, this phase-in does little to mitigate the devastating impact of permanently cutting Medicare home health by 7.85%.

At the same time, the Medicare Payment Advisory Commission (MedPAC) is recommending a 20% cut to the Medicare hospice “aggregate cap.” The hospice “aggregate cap” is an annual per-person dollar limit on the total aggregate payment that any individual hospice can receive in a year for an individual patient. If hospices exceed the cap amount set by CMS, they must repay the excess. The current cap is set at $31,297.61. This is deeply problematic for hospice access and utilization.

Home health and hospice agencies are turning to Congress for help. A bill introduced earlier this year to prevent the home health cut is unlikely to pass before the end of the year, but we expect new legislation when Congress convenes in January.

Our national partners are working hard to prevent the inclusion of a hospice cut recommendation in any end-of-year legislation. As always, we will continue to provide you with updates on home health and hospice news.

Wishing you a joyous holiday season,