Home‑health and Hospice Leaders Urge Payment Fixes, Wider Use of Telehealth to Preserve Rural Access
Get AI-powered insights, summaries, and transcripts
Subscribe
Summary
Home‑health and hospice executives told lawmakers that recent reimbursement cuts, administrative burdens and rising Medicare Advantage enrollment threaten home‑based care; witnesses urged telehealth expansion and performance‑based payment adjustments.
WASHINGTON — Executives representing home‑health and hospice providers told the House Ways and Means Health Subcommittee that payment cuts, administrative complexity and Medicare Advantage practices are straining the sector and reducing access, especially in rural areas.
Dana Madison, an administrator of family‑owned home‑health agencies in West Texas, described decades of payment changes and regulatory shifts that have compressed rural agency margins. She recounted the transition from cost‑based reimbursement to interim payment systems, the 2020 prospective payment and then the PDGM model, and said rural add‑on payments were phased out in 2022. Madison said many staff travel hundreds of miles per week for rural visits and urged Congress to make telehealth and remote monitoring fully reimbursable.
"Most senior citizens in America want to receive care in their home," Madison said. She told the panel that home‑health care is cost‑effective and that telehealth reimbursement and workforce supports are needed to preserve access.
Jonathan Pleece (testifying as the president and CEO of Empath Health) urged stronger support for hospice, saying hospice reduces hospitalizations and preserves patient choice. Pleece and other witnesses described pressures including thin margins, excessive audits and uneven enforcement that penalize providers while some bad actors evade oversight.
Witnesses and members discussed hospice recertification flexibility legislation introduced by Congresswoman Carol Miller that would allow telehealth for hospice recertification visits; Madison and others expressed support for telehealth flexibility that they said would help rural patients and caregivers. Several members also discussed workforce development, remote patient monitoring, and occupational therapy scope changes as ways to streamline discharges and improve post‑acute transitions.
Panelists asked Congress to consider pay‑for‑performance adjustments, better Medicare Advantage oversight for prior‑authorization and reimbursement parity for remote care. No final votes were taken; witnesses offered to provide technical follow‑up and data to the committee.