A recent analysis by CareJourney for the Partnership for Quality Home Healthcare reveals a troubling decline in Medicare home health services, with serious implications for Florida patients. As cuts to Medicare reimbursement rates continue, the data highlights a sharp decline in access to home health services, particularly for those transitioning from hospital care to home settings. The consequences are severe — worse health outcomes for patients and increased costs for the health care system.

• Related: Home Health Access in Decline Amid Shrinking Reimbursement (McKnight's Home Care, September 23, 2024)

Decline in Access and Impact on Patients

In 2023, more than 35% of Medicare patients who were referred to home health services following a hospital discharge did not receive the care they needed within seven days. This delay had a profound impact, with a 41% higher mortality rate among those who didn’t receive timely care compared to patients who accessed care promptly. Additionally, hospital readmission rates were significantly lower — by 34% — for patients who received home health care within seven days of discharge. Moreover, delays in accessing care contributed to an added $2,000 in health care costs per patient over a 90-day period.

These findings point to a critical gap in care that is exacerbating health risks for Florida’s aging population. Home health services play a crucial role in helping older adults manage chronic conditions and recover from hospital stays, yet access to these services is becoming increasingly difficult.

Escalating Referral Rejection Rates

One of the most concerning trends revealed in the analysis is the dramatic increase in home health referral rejections. Nationwide, the referral rejection rate rose from 49% in 2020 to 71% in 2022. This means that more patients are being forced to remain in hospitals, unable to transition to home-based care due to a lack of available services. This bottleneck strains hospitals and home health agencies, leaving vulnerable patients without necessary care.

Medicare Cuts and Their Impact

The decline in access to home health services can be directly linked to recent cuts in Medicare reimbursement rates. Florida’s home health agencies are grappling with rising operational costs and reduced funding, which has severely limited their ability to accept new patients and maintain adequate staffing levels. Proposed 2025 cuts, including a permanent -4.067% reduction, threaten to further erode home health providers' ability to deliver essential services

Disparities in Access

The analysis also revealed significant disparities in access to home health services among minority populations. Racial and ethnic minorities were 10.4% less likely to access home health care compared to their white counterparts. This highlights the need for targeted efforts to ensure equitable access to care, regardless of background or socioeconomic status.

A Call for Legislative Action

Home health advocates are urging policymakers to take immediate action to address these challenges. The Preserving Access to Home Health Act (S.2137/H.R.5159) would halt future Medicare cuts and help ensure continued access to home health services for millions of Medicare beneficiaries. Additionally, advocates urge the Centers for Medicare & Medicaid Services (CMS) to reconsider the 2025 cuts given the data showing declining access and poorer outcomes.

The data is clear: cuts to Medicare home health services are having a devastating impact on patient access and outcomes in Florida. As referral rejection rates climb and more patients are left without the care they need, the time for action is now.

Join the home health provider community in advocating for the Preserving Access to Home Health Act. Click here to contact your members of Congress and urge them to support this crucial legislation to protect access to home health care.