Home Health Final Rule Creates Cloud Over NAHC Annual Conference

HomeCare News

ST. LOUIS (October 25, 2022)—As the National Association for Home Care & Hospice’s (NAHC) Annual Convention and Expo concluded today in St. Louis, Missouri, one issue loomed over the attendees: What will happen with the federal government's home health final payment rule, which must be released no later than Nov. 2? 

“We have people checking the Federal Register every day at 4:15 Eastern,” said NAHC President Bill Dombi in his address to the conference, which was attended by almost 3,000 people in the home health, personal care and hospice  industry.

“You have a range of action,” Dombi told HomeCare, “from where the rule doesn’t change, and you have the 7.69% cut and whatever inflation adjustments … The other extreme is where [CMS] begs forgiveness for the big mistake they made.” 

Find a summary of the proposed rule here.

NAHC holds the position that home health providers have been chronically underpaid; however, CMS applied the payment adjustment in the proposed rule because it believes providers have been overpaid due to behavioral changes under the Patient Driven Groupings Model.

Dombi said he expects to see some cuts, but providers could also see a higher inflation adjustment, which would result in a flat payment rate. CMS has also floated the idea of phasing in the payment cut, Dombi said, but the association and industry rejected that proposal, citing that even phased in cuts would harm patient care.

“Do you want to die now or die next year?” he said. 

A NAHC study of the industry found that 44% to 51% of home health business would operate in the red in 2023 if the cuts go through as proposed.

On the positive side, Dombi said that advocacy surrounding the rule is the most intense he’s seen in his lifetime. Industry allies in Congress have stepped up, as well, he said. 

"In four months, NAHC members have sent 60,000 emails, tweets, phone calls, etc.," Summer Napier, NAHC director of grassroots advocacy, said in a separate address. "This is more than double the next highest action alert. We've also gained 16,000 additional advocates" from across the spectrum of care—including patients and family members of NAHC members.

"We don't know what the final rule will hold," Napier added. "But, we want you to know your efforts have not been in vain."

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