Medicare Payment Policy

Home health care services
Chapter summary
Home health agencies provide services to beneficiaries who are homebound
and need skilled nursing or therapy. In 2011, about 3.4 million Medicare
beneficiaries received home care, and the program spent about $18.4 billion
on home health services. The number of agencies participating in Medicare
reached 12,199 in 2011.
Assessment of payment adequacy
The indicators of payment adequacy for home health care are generally
positive.
Beneficiaries’ access to care—Access to home health care is generally
adequate: Ninety-nine percent of beneficiaries live in a ZIP code where a
Medicare home health agency operates and 98 percent live in a ZIP code with
two or more agencies.
• Capacity and supply of providers—The number of agencies continues
to increase, with over 700 new agencies and 12,199 total agencies in
2011. Most new agencies were concentrated in a few states, and for-profit
agencies accounted for the majority of new providers.
• Volume of services—In 2011, the volume of services was level, and
total payments declined by about 5 percent, or $1 billion. The decline
in payments was attributable to a reduction in the Medicare base rate.
C H A p t e R 9
In this chapter
• Are Medicare payments
adequate in 2013?
• How should Medicare
payments change in 2014?
Report to the Congress: Medicare Payment Policy | March 2013
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