On March 15, the Medicare Payment Advisory Commission (MedPAC) released its yearly report to Congress outlining recommendations for lawmakers on payment changes for Medicare. The following recommendations impact hospice and home health:

• Hospice: MedPAC commissioners voted to recommend Congress update the 2023 Medicare base payment rates for hospice by the amount specified in current law for FY2024 and wage adjust and reduce the hospice aggregate cap by 20%. In 2021, MedPAC found the number of hospice providers increased by about 6% as more for-profit hospices entered the market. MedPAC also found that hospice services dropped slightly between 2020 and 2021, from 47.8% to 47.3%.
• Home Health: MedPAC commissioners voted unanimously to reduce base payments to home health agencies by 7%. This is in line with CMS’ 2022 proposed rule, which sought a nearly 8% cut for home health agencies (in CMS’ final rule, the cut was reduced by half as CMS noted the potential negative impacts to reduce the payment in a single year). According to MedPAC’s analysis, Medicare beneficiaries’ use of at home care grew 2.5% in 2021 on a per capita basis and profit margins were “much higher” for 2021 than 2019.