NAHC Newsroom

Press Release | Advocacy, Home Health, Hospice, Legislative, Policy

Home Health Leaders Applaud Introduction of Senate & House Legislation to Strengthen Medicare Home Health Reforms

September 28, 2018

September 28, 2018
MediaContact: Ellen Almond

Home Health Leaders Applaud Introduction of Senate & House Legislation to Strengthen Medicare Home Health Reforms  

Partnership for Quality Home Healthcare and National Association for Home Care & Hospice applaud bipartisan lawmakers for introducing [S.3458, H.R. 6932] to ensure Medicare payment changes are based on actual changes in provider behaviors

WASHINGTON – The Partnership for Quality Home Healthcare and National Association for Home Care & Hospice (NAHC) commend Senators John Kennedy (R-LA) and Bill Cassidy (R-LA) for introducing legislation in the Senate and Representatives Ralph Abraham (R-LA), Garrett Graves (R-LA), Scott DeJarlais (R-TN), Vern Buchanan (R-FL), and Terri Sewell (D-AL) to introducing legislation in the House to improve home health payment reform to ensure beneficiary access to quality care services is not compromised for America’s growing senior population.

The bills (S.3458, H.R. 6932) would amend several provisions of the Bipartisan Budget Act of 2018 (BBA) which adversely affect home healthcare services and could unintentionally threaten access to care for vulnerable home health patients. Specifically, the bills would require Medicare to implement adjustments to reimbursement rates only after behavioral changes by home health agencies (HHAs) that affect Medicare spending actually occur instead of assuming changes might happen. By requiring the payment model to utilize observed evidence of behavioral changes, the bills would ensure a smoother transition to the new payment system, which is the most significant payment change to the home health system in more than 20 years.

“The Partnership applauds this group of Senate and House lawmakers for introducing these vital pieces of legislation, which will better align Medicare payment with patient care by ensuring payment adjustments are made based on observed behavioral changes among providers,” said Keith Myers, Chairman of the Partnership. “With more and more seniors – especially seniors who are frail and suffer from multiple chronic conditions – requiring home healthcare, it is critical that payment reforms are based on actual behaviors, not arbitrary assumptions, so that home healthcare services are not disrupted.”

“Home health services are vital to Medicare beneficiaries. These bills will provide the means to stabilize access to care while Medicare transforms the payment model in significant ways,” stated William A. Dombi, President of NAHC. “Home health services are essential as an innovative and high-quality solution in health care delivery. When enacted, these legislative proposals will go a long way to ensuring that the benefits of home health care are fully realized,” he added.

The bills further ensure budget neutrality while requiring all necessary increases or decreases in payment rates be phased-in at a ceiling of no more than two percent per year to mitigate the risk of service disruptions for Medicare beneficiaries in need of home healthcare.

These pieces of legislation are being introduced as the Centers for Medicare & Medicaid Services (CMS) considers a proposed rule that would cut Medicare reimbursement rates by an arbitrary 6.42 percent – equaling more than $1 billion annually – starting in 2020. Without the behavioral adjustment change, more than 50 percent of HHAs are expected to experience significant reductions in Medicare payment, severely impacting their ability to serve seniors in their community. Previous attempts at assumption-based payment reform caused thousands of HHAs to shutter, limiting access to services for Medicare patients in need of home healthcare their doctors ordered.

The Partnership further stressed that CMS, in modifications to the payment system for Skilled Nursing Facilities (SNFs), has recognized that payment reform should not include modifications based on behavioral assumptions, concluding that CMS did “not have any basis on which to assume the approximate nature or magnitude of these behavioral responses.”  The home health community asks that the same standard be applied to the new home health payment model.


“We look forward to working with champions on both sides of the aisle and in both chambers of Congress to advance these important legislative solutions so that home health providers can continue to do what they do best: provide high-quality home healthcare to seniors in their communities,” concluded Myers.


About the Partnership for Quality Home Healthcare
The Partnership for Quality Home Healthcare was established in 2010 to work in partnership with government officials to ensure access to quality home healthcare services for all Americans. Representing community- and hospital-based home healthcare agencies nationwide, the Partnership is dedicated to developing innovative reforms to improve the program integrity, quality and efficiency of home healthcare for our nation’s seniors. Visit to learn more.

About the National Association for Home Care & Hospice
The National Association for Home Care & Hospice (NAHC) is the voice of home care and hospice.  NAHC represents the nation’s 33,000 home care and hospice providers, along with the more than two million nurses, therapists, and aides they employ.  These caregivers provide vital services to Americans who are aged, disabled, and ill.  Some 12 million patients depend on home care and hospice providers, who depend on NAHC for the best in advocacy, education, and information.  NAHC is a nonprofit organization that helps its members maintain the highest standards of care.  To learn more about NAHC, visit