Federal Update

CMS Proposes Permanent Cuts to Medicare Home Health

VNAs of Vermont member agencies – the state’s designated home health and hospice providers – provide exceptional care to Vermonters to heal and age with dignity at home.

However, federal regulators are now threatening the sustainability of home health access in Vermont and across the country.

The Centers for Medicare and Medicaid Services (CMS) have proposed permanently cutting the Medicare home health base rates by 9.578%, adding a cut of 5.653% onto the 3.925% cut implemented on January 1 of this year.

In July, CMS released their proposed 2024 rule. The rule proposes an even deeper cut than agencies were anticipating, based on signals from CMS last year, to the home health services many Vermonters depend on.

If this cut is implemented, it will threaten access to care. It’s that simple.

We are grateful for the steps the Scott Administration and Vermont Legislature took to support home health and hospice agencies this year, including Medicaid rate increases for skilled and long-term services, workforce investments, and the sunset of the home health provider tax.

However, because Medicare is the largest source of revenue for home health and hospice agencies, full implementation of the CMS-proposed cut will have an outsized impact on the sustainability of Vermont’s system of home health care delivery.

Fortunately, a bill has been introduced in Congress to stop these cuts from happening, and our national association (National Association for Home Care and Hospice, or NAHC) has filed a lawsuit challenging the validity of these changes to the Medicare payment rate.

VNAs of Vermont will continue to fight for stable, sustainable funding, for the vital home health and hospice services Vermonters depend on.

Stay tuned for ways you can help support access to quality, compassionate care at home.

CMS Issues FY2024 Hospice Payment Rule Update

In other CMS news, as a part of the FY2024 Hospice Payment Rule, CMS is providing a 3.1% payment update for 2024 hospice payments and is finalizing policies related to hospice certifying physicians and use of telehealth for the hospice face-to-face encounter.

While 3.1% is a very modest improvement from the 2.8% originally proposed by the agency, it falls far short of keeping pace with the increased costs providers are faced with to deliver care.

The finalized rule also raises the aggregate payment cap to $33,494.01 for next year, up from $32,486.92 set in 2023.

Unfortunately, these increases aren’t keeping pace with wage pressures and a workforce crisis, and rising costs of care like supplies, drugs, and staff travel costs.

There is mounting concern from national advocates that these insufficient payments will have an outsized impact on rural areas, such as Vermont, where many of the financial and workforce pressures facing providers are even more acute.

Jill Mazza Olson Attends National Conference of Home Health Leaders

Last week VNAs of Vermont Executive Director Jill Mazza Olson attended the 2023 leadership conference held by the Council of State Home Care & Hospice Associations.

This annual event provides a valuable opportunity for home health and hospice association leaders like Jill to discuss state challenges, exchange best practices and ideas, and strategize on federal issues impacting our members and the people they care for across the country.

Data on hospital discharges to home health agencies was the focus of one workshop. According to the data gathered by the Research Institute for Home Care, 17% of all hospital discharges in Vermont are to home health agencies; a percentage higher than most states, demonstrating the critical role that VNAs of Vermont member agencies play in hospital discharges. Vermonters who prefer to heal at home are able to do so because of the important services offered by Vermont’s designated home health and hospice agencies.

Workforce challenges were high on the list of discussion topics among association leaders. Jill noted that few of her counterparts identified lack of housing as an issue facing their home health and hospice workforce.

While every state has its own unique obstacles and opportunities, joining together to discuss our individual and shared challenges strengthens our collective ability to find solutions.

Educational Opportunities

Blueprint for Oasis Accuracy - 2 Day Onsite Workshop

September 25-26 | 8 a.m. to 4 p.m.

Hosted by VNAs of Vermont

Southern New Hampshire University

2500 North River Road

Hooksett, New Hampshire 03106

Blueprint for OASIS Accuracy is a 2-day, 13-hour workshop highly focused on the current OASIS data collection rules and instructions, with an optional Certificate for OASIS Specialist-Clinical Exam Administration.

Click here or more information or to register.