The New York Congressional Delegation, led by Representative Ritchie Torres (D-NY), sent a letter to President Biden, Office of Management and Budget (OMB) Director Shalanda Young, and Centers for Medicare and Medicaid Services (CMS) Administrator Chiquita Brooks LaSure expressing concern about CMS’s calendar year 2024 proposed home health payment rule that, LeadingAge agrees, will devastate access to home health care services.

The October 23 letter states, “This will further exacerbate the formation of ‘home health deserts’ across the state and the country, where there will be virtually no workforce available to provide home health care in urban, rural, and suburban communities. These cuts would further the racial and income disparities in home health care.”

The letter also includes data directly related to the impact of the rule on New York state:

• New York state (NYS) hospital referrals to home health agencies increased 79% between 2019 and 2022, but home health agencies lack the capacity to keep up with the growing number of referrals. Last year, NYS home health agencies were able to take in fewer than 25% of hospital referrals. This is consistent with trends throughout the United States.
• For related reasons, NYS Medicare home health admissions have declined by 6% over two and a half years. All regions are impacted, but upstate regions have been hit particularly hard, including 32% in the Finger Lakes region, 23% in the Capital District, and 19% in the Southern Tier. In New York City, the Bronx had the steepest decline, also at 19%.
• At least three home health agencies in upstate New York have filed closure plans in 2023, which will worsen challenges for the providers that are able to stay open.
• There has been a sixfold increase in the rate at which patients were turned away from home health services due to staffing shortages from 2019 through 2022.
• The average length of hospital stay for patients referred to home health care increased 11% from 2019–2022, indicating patients are waiting longer to be discharged safely.