This article shares data HCHB shared about the growing access-to-care issues in the Home Health industry. Homecare Homebase reports that more than 4.3 million patients are turned away from home health services annually, as referral-to-admission rates have fallen from 74% pre-PDGM to about 64% today. Drawing on data representing 44% of Medicare home health claims, the analysis attributes the decline primarily to staffing shortages and flat reimbursement, pressures that could be exacerbated by proposed 6.4% Medicare payment cuts. Small and rural agencies are especially vulnerable, with rising labor and operational costs and greater exposure to typically lower-paying Medicare Advantage plans. HCHB’s Home Health Impact Model and Advocacy Dashboards use de-identified data to assess financial and operational impacts, tracking factors like labor costs, case-mix, and per-visit rates. The company also challenges CMS’s assumption of diagnosis inflation under PDGM, finding little difference between intake and final claim diagnoses. HCHB is working with advocacy groups to bring these data to CMS to prevent further erosion of patient access.
