Webinars
Impacts of the 2025 Proposed Rule
Exploring the effects of MA and Medicare rate cuts through data
Medicare rate cuts, an inflationary environment, workforce shortages, and payer mix changes favoring Medicare Advantage have led to increasing access to care challenges for the Home Health Industry. In the face of the 2025 Proposed Rule, Homecare Homebase has joined forces with providers to help advocate for the industry. Watch this webinar with John Gochnour, President and Chief Operating Officer for Pennant Group and Scott Pattillo, Chief Strategy Officer for Homecare Homebase to dive into the greatest challenges facing the Home Health industry and how we can work together to continue providing high quality care to as many patients as possible.
Learning Objectives:
Uncover the effects of Medicare Advantage rates on the home health industry
Discover the effects margin erosion is having on access to care
Learn how to account for CMS’ proposed rate cuts
Explore avenues for industry advocacy
Gain tips for overcoming market challenges
Presenters:
John Gochnour, President and Chief Operating Officer, Pennant Group
Scott Pattillo, Chief Strategy Officer, Homecare Homebase
Joyce Famakinwa, Senior Health Care Reporter, HHCN
The Potential Impacts of the 2025 Medicare Proposed Rule
This year, the Centers for Medicare and Medicaid Services (CMS) is proposing an estimated -1.7% overall cut, along with wage index adjustments. The wage index adjustments change from state to state, ranging from -4.87% to 8.74%. Why are these numbers significant?
- The wide range of impacts means that states will receive drastically different impacts from the proposed rule.
- Wage index changes have caused a lot of chaos and instability over the last few years, often increasing one year, decreasing the next and then increasing again.
- The proposed cuts do not reflect the increasing costs for providing care in an inflationary environment.
Watch the webinar or download the webinar presentation slides to view the charts and data analysis supporting these points. You can also dive deeper into the explanation of these impacts by reading the HCHB comment letter.
How Medicare Advantage Affects the Industry
Medicare Advantage payors typically pay significantly less that Medicare. In fact, HCHB’s data analysis indicates that revenue per visits for MA payors as a whole is -11.7% under the estimated cost per visit. As Medicare Advantage payors have gained market share this has become increasingly problematic for agencies. The combination of an inflationary environment, increased number of Medicare Advantage patients and Medicare cuts has dropped Home Health industry margins into the single digits.
How the Industry is Coping with Changes
Finding efficiencies through leaning down operations, increased adoption of technology and decreasing the number of visits per patient have been some of the key strategies Home Health providers have had to employ to remain profitable. Clinicians are now seeing 1.4 more patients than in 2019 and agencies are providing an average of 2.9 fewer visits for each patient during an episode of care than in 2020. Essentially, providers are having to lower the number of visits per patient to lower costs and increase margins, but every time they do so, additional rate cuts remove the margin they have worked to gain.
Additionally, Home Health providers have had to turn away an increasing number of patients due to workforce shortages and increased costs of care. The percentage of beneficiaries converted to admits for Home Health has dropped by 10% since 2020 alone.
Key Takeaways from the Webinar:
Scott Pattillo and John Gochnour closed out the webinar with a summary of arguments that providers can include in their own advocacy efforts.
- Rate cuts have led to reduced visits and access to care issues. This strategy has been a necessity for maintaining margins however and should be avoided through rate increases rather than further cuts. Additionally, access to care issues are leading to fewer patients receiving the benefits they are paying for.
- Margin estimates should include three key factors. Current margin estimates do not take inflation, reduced MA payment rates or increased costs into account properly. Not including these factors leads MedPAC and CMS to believe agencies have higher margins than they actually do.
- Frequent wage index changes fuel instability. The frequency and range of payment wage index changes year to year create instability and confusion in the industry.
Conclusion
This webinar showcases how HCHB and providers are working together to provide data-driven arguments that help paint a more accurate picture of the home health industry for CMS and lawmakers. Viewers also learn ways to leverage analytics to prepare for future regulatory changes, Medicare Advantage negotiations and other ways technology can uncover further efficiencies. Contact us to learn more about how HCHB can help your organization’s advocacy efforts.
