Greg Steube Asks Expert: What Factors Are ‘Driving This Widespread Closure Of Home Health Agencies’?

15 hours ago

During a House Ways and Means Committee hearing held before the congressional recess, Rep. Greg Steub (R-FL) questioned witnesses about the hurdles home health agencies face.

Fuel your success with Forbes. Gain unlimited access to premium journalism, including breaking news, groundbreaking in-depth reported stories, daily digests and more. Plus, members get a front-row seat at members-only events with leading thinkers and doers, access to premium video that can help you get ahead, an ad-light experience, early access to select products including NFT drops and more:

https://account.forbes.com/membership/?utm_source=youtube&utm_medium=display&utm_campaign=growth_non-sub_paid_subscribe_ytdescript

Stay Connected
Forbes on Facebook: http://fb.com/forbes
Forbes Video on Twitter: http://www.twitter.com/forbes
Forbes Video on Instagram: http://instagram.com/forbes
More From Forbes: http://forbes.com

Transcript

00:00Stubbe, you're recognized. Thank you, Mr. Chairman. Mr. Fleece, thank you for all the work that you've

00:04done in my district. The number of home health providers has declined significantly, excluding

00:10California. The number of agencies serving beneficiaries has dropped by 17 percent since 2019

00:16from 7,793 to 6,468. A publicly traded home health company recently announced the closure of multiple

00:23agencies, particularly in rural areas, citing reimbursement cuts as the primary reason. Can

00:28you provide insight into the factors driving this widespread closure of home health agencies,

00:33and do you believe current reimbursement policies are sustainable for providers?

00:38Thank you, Congressman Stubbe, and we do thank you for your service to the district

00:43where Empath Home Health serves, as well as Tidewell Hospice, so thank you, sir.

00:49Ultimately, home-based care is so much of the solution to many of the questions and many of

00:55the problems that have been identified today at this subcommittee. Ultimately, as I co-authored

01:02in my book, The New Health Age, how we think about health care, how we deliver health care,

01:07and the economics of health care must change, and there are many, many reasons behind that.

01:13I concur that there are various models within the home-based care environment that are driving

01:21especially smaller home-based care agencies out of business, and even for larger not-for-profit

01:26organizations like myself, caring for 80,000 Floridians a year, programs like PDGM, programs

01:34like Reviewed Choice Demonstration, the complex OASIS tool that our staff are forced and required

01:43to comply with, while well-intended when enacted, certainly do require further consideration to

01:51reduce administrative burden, to ensure that home-based care and patient care survives,

01:57and in all due respect, in my final comment to one of my panelists that's testifying today,

02:05I practiced health care law for 25 years and have been in health care for 30, serving as a CEO or

02:10president of this organization, and I'm hard-pressed, hard-pressed to find a lot of home

02:16care agencies, as identified by MedPAC, with 20-plus percent margins. We are operating at a

02:222 percent, that's 2 percent net operating margin across Empath Health and the care continuum,

02:28and our home health care division is operating at a net loss.

02:31And under the new home health payment systems, are payments covering providers' costs?

02:37Absolutely not, Congressman.

02:39And how inadequate are fee-for-service payments relative to cost?

02:44Inadequate. And when Medicare Advantage is continuing to grow, while there are good

02:49implementations and five-star rated Medicare Advantage plans across this country that has

02:56been longstanding, we need to continue to move towards a pay-for-performance model and also pay

03:02the four- and five-star hospice and home health agencies more so that we're paying for performance

03:08under the model. And can you speak to your experiences

03:11with prior authorization? Are most of the requests approved? How does this impact the care received?

03:18So, I would ask for the Congress here today to imagine one of your loved ones in either hospice

03:26or home health, and they are in need of post-acute care. Every second, every minute is critical to

03:34get them out of the hospital into a home-based care environment. We both participated under the

03:41Medicare Advantage Carvin pilot on the hospice side, and we contract with Medicare Advantage

03:47plans today. It adds hours, days to the pre-authorization process and delays access

03:55and delays care. Oftentimes, on the hospice side and sometimes even on the home care side,

04:00patients literally die during the discharge planning process waiting for the authorization,

04:06Congressman. In the little bit of time I have remaining, is there any issues you'd like to

04:10address that you haven't had the opportunity to address so far? Thank you so much, Congressman.

04:15One thing I can guarantee every congressperson here today is that we will all die. If I compel

04:23you to take one takeaway today from this subcommittee hearing, it's preserve the end-of-life

04:32care benefit that hospice has been known for for over 45 years in the Medicare benefit.

04:38Thank you so much. I yield back. Thank you for being here.

Greg Steube Asks Expert: What Factors Are ‘Driving This Widespread Closure Of Home Health Agencies’?

Category

Transcript

Recommended