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Committee hears calls to overhaul MassHealth rate-setting for home health and home care
Summary
Providers and industry groups backed H767/S870 to require transparency and updated methodology for MassHealth home health and home care rate-setting, linking inadequate rates to workforce shortages and delayed discharges from hospitals.
BOSTON — Home health and home care providers told the Joint Committee on Health Care Financing on Wednesday that an opaque and outdated MassHealth rate-setting process is a leading cause of staffing shortages that leave thousands waiting for in-home services.
“Home care services are a vital and growing part of the health care delivery system,” said Harrison Collins, director of legislative and public affairs at the Home Care Alliance of Massachusetts. He told the committee agencies are turning down referrals because they cannot hire enough workers and that delayed discharges from hospitals are increasing costs. “The leading reason for the workforce shortage is inadequate rates that lead agencies to be unable to compete,” Collins said.
What the bill would do: H767/S870, proponents said, would not itself set rates but would require the Executive Office of Health and Human Services to disclose the methodology and include specific cost factors — such as changes to state minimum wage, paid family leave, employer payroll taxes, benefits and training — when promulgating home health and home care rates. Julie Watt Fekir, executive director of the Home Care Aide Council, said the proposal would add “transparency as to the methodology and criteria used to set home care and home health rates.”
Evidence: Multiple provider witnesses said patient waitlists are growing. Collins cited a February 2025 report indicating 717 patients in 45 hospitals were waiting for discharge to home health, with 24% waiting more than 30 days. Providers said home health aide rates had not kept pace with rising costs and worker expectations; several witnesses noted that home health rates were unchanged for long periods before recent increases.
Provider requests and safeguards: Providers asked the committee to require that EOHHS consider operating costs in rate calculations and to report to the Legislature on how rates affect access. Panelists emphasized the bill preserves the state’s prerogative to set rates while creating accountability and data reporting so policymakers can weigh funding decisions.
Committee process: Chairs reminded witnesses that written testimony would be accepted through Aug. 22 and that House matters must be reported by Aug. 30. Advocates urged a favorable report to prompt more detailed fiscal analysis from MassHealth and to guard against further erosion of the in-home workforce.
