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New BPC Report Examines the Medicare Home Health Benefit

Washington, DC – Amid rising health care costs, a growing aging population, and recent COVID-19 concerns, the move to providing health care in-home is more of interest now than ever before. While more than 3 million fee-for-service Medicare beneficiaries received home health services in 2019, the benefit often does not adequately address the needs of beneficiaries with multiple comorbidities or complex conditions. There is also evidence supporting the use of home health services in both improving outcomes and reducing costs. According to a study of Medicare fee-for-service beneficiaries, home care was associated with a savings of nearly $6,500 per patient. 

As the attention on “home-based care” continues and policymakers consider legislation on the issue, the Bipartisan Policy Center’s Health Project identified key factors that have a harmful effect on care delivery and made recommendations for improving the Medicare home health benefit in a new report, Optimizing the Medicare Home Health Benefit. 

Particularly of note, the report’s policy recommendations can be adopted under the current regulatory framework and Centers for Medicare and Medicaid Services authorities. Recommendations include:  

  • Streamlining coverage and eligibility determinations to improve the administering of benefits and prevent unwarranted coverage denials; 
  • Ensuring that quality metrics and payment policies reward whole-person care; 
  • Optimizing service availability to ensure beneficiaries receive the services for which they qualify; and  
  • Improving beneficiary experiences.  

The report concludes: “Guardrails will remain important as both the Medicare population and health care spending continue to increase. However, the adverse effects of Medicare policies should be minimized to the extent possible. … As we continue our work on chronic care and better integration of health care services, we will promote patient-centered policy across federal programs. We look forward to additional opportunities to drive policy that ensures Medicare beneficiaries are able to receive the services they need in the most cost-effective way possible.” 

Support for this report was provided by the Commonwealth Fund 

Read the full report.