When diagnostic-related groups (DRGs) became law in 1983, home care emerged as the savior. The traditional fee-for-service model of reimbursement encouraged long hospital stays and unnecessary diagnostic and treatment interventions. Patients remained in the hospital for days if not weeks. Under the DRG system, hospitals would be reimbursed by diagnoses rather than number of days in the hospital or tests performed. The length of stay for hospital admissions would have to be drastically curtailed for hospitals to remain financially viable. It sent shockwaves through healthcare systems. The only feasible path forward was through home care. Home care made the transition to the DRG system of reimbursement achievable and safe for patients.
After decades of being the means by which billions of dollars were saved, home care is now threatened. The Centers for Medicare and Medicaid Services plans to reduce reimbursement to home healthcare agencies by 18 billion dollars over the next 10 years (Hammon, 2022). This proposed reduction comes at a time of critical staff shortages, a pandemic that won't go away, supply chain interruptions, and rising gas prices. A reduction of 1.33 billion in 2023 was planned for 2023, but because of strong pushback by the industry, this decision was reversed. Although there will now be a .7% increase in reimbursement in 2023, this issue is not going away.
Advocacy and political action are needed. U.S. Representatives Sewell (D-Alabama) and Vern Buchanan (R-Florida), and Senators Debbie Stabenow (D-Michigan) and Susan Collins (R-Maine) have introduced bipartisan bills to the U.S. House and Senate to prevent reductions in home care reimbursement until 2026. Write to your senators and representatives in support of the Preserving Access to Home Health Act of 2022. Tell them what you do and how home care makes the difference in the lives of millions of patients.
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