CMA Survey | Medicare Home Health Beneficiaries Likely Misinformed and Underserved

	_____________________    SPECIAL REPORT     _____________________
___________________ Center For Medicare Advocacy Home Health Survey: Medicare Beneficiaries Likely Misinformed and Underserved December 16, 2021 Home health services authorized by Medicare home health law, regulations, and policies[1] are too often unavailable in practice. From April 28, 2021- November 19, 2021, the Center for Medicare Advocacy (the Center/CMA) conducted a survey of 217 Medicare-certified home health agencies (HHA) in 20 states to learn more about what beneficiaries experience.[2] The agencies were identified through the Care Compare search tool at www.medicare.gov. The Center inquired about home health services available from each agency for a hypothetical patient with an authorized practitioner’s order certifying one hour of physical therapy per week, one hour of skilled nursing per week, and 20 hours of home health aide services per week. All agencies indicated that they would be able to provide one hour of physical therapy per week, and 99% said they could provide one hour of skilled nursing care per week. Responses about home health aide services, however, were very different. 15% of agencies did not provide a clear answer regarding available home health aide services. Those that did provide an answer demonstrated overwhelmingly that home health aide services are not available in an amount even approaching the benefit as defined by Medicare law. This trend was present in rural and urban areas across all 20 states surveyed.[3] Further, in order to see if accurate information about the Medicare home health benefit is available from the Centers for Medicare & Medicaid (CMS)– the federal Medicare agency – the Center made ten calls to the official CMS Medicare help line, 1-800-MEDICARE. Center staff asked the same questions regarding services available for the same hypothetical patient as they asked home health agencies in the survey. Unfortunately, the information provided by 1-800-MEDICARE was inconsistent and often inaccurate. Download and read the full report at report at: https://medicareadvocacy.org/wp-content/uploads/2021/12/CMA-Survey-Medicare-Home-Health-Underservice.pdf ___________________ [1] The Medicare Home Health Statute is available at 42 USC §1361(m); Regulations available at 42 CFR 409 et seq; Policy available at Medicare Benefit Policy Manual (cms.gov). [2] From 4/28/21-7/26/21, calls were made to agencies in the following 19 states: AZ, CA, CT, FL, GA, IL, KS, LA, MD, MA, MN, NY, OH, OR, PA, TX, UT, WV, WY. To confirm that findings are persistent and widespread, on 11/19/21 additional calls were made to agencies in MI. [3] Results are based on information communicated directly by agency representatives. The actual provision of services as stated by agencies has not been independently verified. While we originally planned to produce a directory of care available from surveyed home health agencies, the results of the survey demonstrated that available care is so limited, a directory does not seem useful. Share         Center for Medicare Advocacy, Inc. • www.MedicareAdvocacy.org PO Box 350, Willimantic, CT 06226 • 1025 CT Ave. NW, Washington, DC 20036