Bill Overview
Title: Preserving Access to Home Health Act of 2022
Description: This bill restricts the Centers for Medicare & Medicaid Services (CMS) from decreasing payments for Medicare home health services based on certain adjustments until 2026. Current law requires the CMS to make certain permanent and temporary payment adjustments under the Medicare prospective payment system for home health services based on behavioral assumptions for 2020 through 2026. The bill restricts the CMS from making adjustments that decrease payments until 2026; the CMS must also ensure that any such necessary decreases are made before 2032.
Sponsors: Rep. Sewell, Terri A. [D-AL-7]
Target Audience
Population: People who rely on Medicare-funded home health services
Estimated Size: 12000000
- The bill impacts individuals who rely on Medicare home health services, ensuring the payments for these services are not decreased based on certain adjustments until 2026.
- Home health care primarily serves elderly patients, people with chronic illnesses, or those who need rehabilitation after surgery.
- Medicare is a federal program, so its beneficiaries are US citizens and legal residents 65 years or older, or younger individuals with certain disabilities.
- The bill affects healthcare providers and home health agencies who deliver these services by impacting their reimbursement rates.
Reasoning
- The policy is designed to prevent a decrease in funding which could otherwise negatively impact the wellbeing of individuals who depend on Medicare-funded home health services. Maintaining funding levels is expected to ensure continued access to care, which is crucial for maintaining quality of life, particularly for the elderly and those with chronic health conditions.
- Individuals relying on these services tend to have lower mobility and greater health needs, making consistent home health visits vital to their wellbeing.
- Healthcare providers and agencies also benefit from stabilized payments, allowing them to maintain or improve the quality and availability of services.
Simulated Interviews
retired (Florida)
Age: 70 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 8.0 years
Commonness: 18/20
Statement of Opinion:
- Home health care has been crucial to my recovery process.
- I worry about funding cuts impacting the availability and timeliness of my care.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 7 | 4 |
| Year 3 | 7 | 3 |
| Year 5 | 6 | 2 |
| Year 10 | 6 | 1 |
| Year 20 | 5 | 1 |
retired (Texas)
Age: 82 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 16/20
Statement of Opinion:
- My condition requires frequent monitoring and care.
- Keeping funding stable ensures my health needs are adequately met.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 4 |
| Year 3 | 7 | 3 |
| Year 5 | 7 | 3 |
| Year 10 | 6 | 2 |
| Year 20 | 5 | 2 |
retired (California)
Age: 65 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 15/20
Statement of Opinion:
- Stability in payments means stability in care.
- Cuts could mean fewer visits from healthcare professionals.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 6 | 3 |
| Year 20 | 5 | 2 |
disabled (New York)
Age: 54 | Gender: other
Wellbeing Before Policy: 4
Duration of Impact: 15.0 years
Commonness: 12/20
Statement of Opinion:
- These services are essential for my daily functioning.
- I'm concerned about what reduced funding would mean for my care.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 3 |
| Year 3 | 6 | 3 |
| Year 5 | 6 | 2 |
| Year 10 | 5 | 2 |
| Year 20 | 4 | 1 |
retired (Ohio)
Age: 76 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 15/20
Statement of Opinion:
- Stability in funding is crucial for my wife's care.
- Cuts could severely disrupt our lives.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 7 | 3 |
| Year 3 | 7 | 2 |
| Year 5 | 7 | 2 |
| Year 10 | 6 | 1 |
| Year 20 | 5 | 1 |
retired (Pennsylvania)
Age: 68 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 14/20
Statement of Opinion:
- Home visits have been vital in my recovery journey.
- Stable funding directly alleviates stress about future accessibility.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 7 | 3 |
| Year 3 | 7 | 3 |
| Year 5 | 7 | 2 |
| Year 10 | 6 | 2 |
| Year 20 | 5 | 1 |
retired (Illinois)
Age: 79 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 14/20
Statement of Opinion:
- Medicare home health is my lifeline, especially as I live alone.
- Cuts could leave me isolated and at risk.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 3 |
| Year 2 | 6 | 2 |
| Year 3 | 7 | 2 |
| Year 5 | 6 | 1 |
| Year 10 | 5 | 1 |
| Year 20 | 4 | 1 |
disabled (Michigan)
Age: 62 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 8.0 years
Commonness: 11/20
Statement of Opinion:
- Constant care is required due to my heart condition.
- Funding stability ensures continued access to necessary healthcare.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 6 | 3 |
| Year 10 | 6 | 3 |
| Year 20 | 5 | 2 |
unemployed (Arizona)
Age: 59 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 12.0 years
Commonness: 13/20
Statement of Opinion:
- I rely on home health services for therapy.
- Concerns about future cuts directly affect my mental wellbeing.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 3 |
| Year 2 | 5 | 3 |
| Year 3 | 6 | 3 |
| Year 5 | 6 | 2 |
| Year 10 | 5 | 2 |
| Year 20 | 4 | 1 |
retired (Colorado)
Age: 71 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 17/20
Statement of Opinion:
- Regular check-ups at home help me manage arthritis pain.
- I'm relieved that funding cuts are temporarily on hold.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 3 |
| Year 2 | 6 | 2 |
| Year 3 | 7 | 2 |
| Year 5 | 6 | 1 |
| Year 10 | 5 | 1 |
| Year 20 | 4 | 1 |
Cost Estimates
Year 1: $500000000 (Low: $400000000, High: $600000000)
Year 2: $500000000 (Low: $400000000, High: $600000000)
Year 3: $500000000 (Low: $400000000, High: $600000000)
Year 5: $0 (Low: $0, High: $0)
Year 10: $0 (Low: $0, High: $0)
Year 100: $0 (Low: $0, High: $0)
Key Considerations
- The policy may lead to higher initial costs which could stabilize over time.
- Potential for long-term impacts on CMS financial planning and Medicare solvency.
- Possible impacts on the labor market for home health aides and allied health professionals.