Point of View

The ACA’s cuts to Medicare threaten home health care jobs, patients

February 5, 2014 

Today in Raleigh, clinicians and families representing our state’s home health community will gather to call needed attention to a health care issue that is threatening access to care for our state’s elderly as well as valuable health care jobs.

In North Carolina, more than 40,000 health care professionals are employed by the home health sector, which has meant steady paychecks, investment in small businesses and – most importantly – exceptional care for a rapidly growing number of seniors.

Over the last decade, the nation’s home health community – a sector that allows American seniors to age at home while receiving cost-effective care – has contributed nearly 600,000 jobs to the U.S economy. Since 2003, our sector’s workforce has grown by 89 percent.

However, steep Medicare home health cuts implemented as part of the Affordable Care Act put this growth at considerable risk. Newly implemented administration policies, which slash home health care funding by 14 percent over the next four years, are already resulting in a downturn in job growth, according to the U.S. Bureau of Labor Statistics.

Now, unfortunately for our patients and our state’s economy, these new cuts will force approximately 40 percent of all home health providers to operate at a net loss – meaning they will face the risk of bankruptcy and closure. The federal Medicare agency’s own estimate means that this regulation will directly affect nearly 5,000 small-business providers that today serve nearly 1.5 million seniors and are responsible for nearly 500,000 jobs from coast to coast.

In North Carolina, estimates indicate that nearly 28 percent of our home health agencies will be forced to operate at a net loss by 2017. These agencies at greatest risk serve 29,224 seniors and employ 11,356 North Carolinians – who will likely find their care and their jobs in peril.

The administration had the flexibility not to implement significant reductions yet chose to move forward despite warnings from lawmakers, senior advocates and small-business leaders that such cuts could limit patient access and lead to job loss.

Home health is too valuable to seniors, to the economy and to our health care delivery system to be put at such risk.

Most older Americans who have been hospitalized are likely familiar with home health care. When discharging patients from acute care settings, doctors will often prescribe ongoing services to be provided by skilled practitioners in the patient’s own home. In recent years, home health has evolved, allowing for more advanced care and management of complex medical conditions. Home health care allows patients to recover from illness, regain function and improve their overall health status in the comfortable, convenient and cost-effective home setting.

Many primary care physicians also recommend various home health care services to keep patients healthy, manage chronic conditions and avoid complications that could send them to the emergency room or other expensive institutional settings. In rural parts of our state especially, home health care may be the only option for seniors who are unable to visit a physician’s office, clinic or hospital

Home health works, and it saves precious Medicare dollars.

With an estimated 10,000 Americans becoming Medicare eligible every day, it is time to encourage the use of home health, which not only reduces Medicare spending through lower-cost care but allows patients to remain at home. Studies by AARP find that is what 9 in 10 seniors and their families prefer.

The ACA’s Medicare home health cuts are a misguided approach for seniors, the nation’s workforce and health care spending. That is why we are asking Washington to look closely at the 14 percent cut and its overall impact on senior care and jobs – and provide the relief our sector needs to ensure we can continue to provide the quality home health services more and more Americans demand.

Connie Dolin is a home health clinician based in Charlotte who has worked in the home health sector for 13 years.

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