November 1, 2024 Washington, DC — A statement from Katie Smith Sloan, president and CEO, LeadingAge, the association of nonprofit providers of aging services, including home health, on the Centers for Medicare and Medicaid Services’ (CMS) release of the Home Health Prospective Payment System Final Rule for CY2025:

“Though the final payment rule released today is a net aggregate payment increase of 0.5%, or $85 million, this number must be put into context. Although CMS has spread out the baseline cuts, the rule nonetheless finalizes a -1.975% permanent projected adjustment. This brings us to a nearly 9% permanent cut to home health payment since 2023. At the same time, a $4.5 billion temporary adjustment looms. 

This combined reduction in payment will harm older adults and families in need of care and the providers who are doing their best to deliver it. Our nonprofit, mission-driven agency members are at risk. We are already seeing provider closures. This is simply unsustainable. 

While we recognize CMS provided warning of potential future cuts to home health agencies in previous years’ rule making, the reality is that many providers are navigating a challenging economic environment, including a highly competitive labor market. As a result, even with the agency’s warning, many providers have no further ability to tighten their belts. Future payment reductions and clawbacks are a certainty under the agency’s interpretations of its current statutory obligations. Simply put, without a change in course by Congress and by CMS, access to care will continue to decline. LeadingAge will continue to advocate for a strong home health benefit and for relief for our members. 

Regarding the finalization of Conditions of Participation (COP): We believe CMS made the wrong decision to implement a COP that will not solve the problem of access to care. Without any request for information (RFI) to understand the problem, or any analysis of its data to identify the root cause of agencies’ turning down requests for care, CMS finalized additional administrative burdens to home health agencies. This will not yield the desired result.  LeadingAge has, for each of the past three years, shared with CMS our concerns about referral rejection rates and we strongly disagree with CMS’ position that this purported lack of transparency from home health agencies is the root cause of the delay in access.

Long-Term Care (LTC) Facility Acute Respiratory Illness Data Reporting: We are disappointed in CMS’s insistence on continued reporting at pandemic level-frequencies, and note the additional burden of expanding reporting to include other respiratory illnesses. At the same time, we are pleased with the agency’s decision to streamline reporting compared to current requirements. We attribute this to our members’ resolute advocacy on this issue, which we believe has informed CMS’ decision to allow requirements for reporting of healthcare personnel data to expire and to not finalize provisions that would have increased reporting requirements in the event of a likely public health emergency. Our members join us in urging CMS to immediately address the not-yet-resolved issue of duplicative reporting that is caused by reporting resident vaccination data through both NHSN and the Minimum Data Set. Our advocacy on this issue will continue.”