Life in rural North Carolina is picture perfect: fresh air, friendly neighbors, welcoming churches and quiet, family-oriented communities. Who would want to give this all up just because they get sick?
Very few would, which is why home health services are so important for older North Carolinians. Since 1981, the nonprofit agency I lead has been honored to serve thousands of seniors across our state, helping families, children, parents and grandparents access care at home during their most difficult times.
Unfortunately, years of successive Medicare cuts are pushing home health care providers like us to the brink. And now, even deeper Medicare cuts threaten to further erode patient’s access to home health. Every senior deserves to choose where they would like to get health care and grow old.
For many patients and their families, home health is a blessing. After being hospitalized with a serious injury or illness, many opt to continue getting the care they need in the comfort of their own homes. While each person’s treatment is different, this may mean getting physical therapy, skilled nursing care, wound care, medication management and much more. Because the Medicare Home Health benefit helps older Americans stay close to loved ones, it is no wonder that over 90% of seniors prefer to recover at home instead of in a nursing home or other institutional setting.
Since 2020, the federal government has slashed precious funding from this vital Medicare program — cuts expected to total $25 billion over 10 years. These cuts have hit providers hard. To stay afloat, we’ve been forced to eliminate extra services that have historically not been reimbursed, including telehealth. Medicare’s home health cuts have hit our workforce hardest. As any hospital can tell you, it’s hard enough to recruit nurses and other key staff. With so many health care workers leaving during the pandemic, how can we hope to offer attractive wages to attract new talent if our Medicare reimbursement is under siege?
Moreover, some home health providers in North Carolina have had to close their doors or turn away some Medicare patients who need help transitioning out of the hospital. This, in turn, creates more challenges for small organizations like ours, who want to help every single patient referred to us but can’t. To try to make up for the staffing shortfall in the face of unprecedented demand, we have little choice but to limit our capacity and caseload.
Ultimately, if the cuts continue, the pressure on home health providers will rise to a fever pitch, and I fear the Medicare Home Health benefit won’t be accessible to rural Americans who can’t find a local provider. If the worst comes to pass, older North Carolinians will be forced to stay in the hospital longer (which is the most expensive and least patient-preferred setting) or go to nursing homes in cities that may be quite far from their families.
We’re a small nonprofit operating in rural areas — but our problems are not unique. Home health agencies across North Carolina and throughout the country face similar challenges. Given all these challenges, why is Washington calling for even greater cuts to Medicare home health when they should be protecting this vital program?
To ensure seniors can get the health care services they need in their own homes, policymakers in DC must reject additional cuts to home health in future years. After all, most seniors have deep roots in their communities and want to stay near loved ones — why should they be robbed of that choice by federal government funding cuts?
It’s up to Congress to stand up against home health cuts and protect this choice for their constituents.
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