KIMBERLY, Wis. (WFRV) – The Wisconsin Association for Home Health Care is calling on the state to increase the Medicaid reimbursement rate for home health services in a recent opinion editorial sent to Local Five.
It said, “Such low Medicaid reimbursement levels create a critical workforce crisis for home health care agencies to retain essential skilled nursing staff and adequately serve Wisconsin’s home health care patients.” [Full text can be found below]
Greg Von Arx, the Secretary and Treasurer for the Wisconsin Association for Home Health Care said, “The Medicaid rates haven’t increased in the 12 years that I’ve been involved in Wisconsin.”
He this is not a viable business model.
“What ends up happening is the Medicaid clients aren’t being seen because we are really being forced to take more insurance and more Medicare clients to be able to survive,” said Von Arx.
The biannual state budget is currently up for debate so lawmakers have a chance to change these rates.
Rep. Lee Snodgrass, (D) Appleton, “We need to make sure we keep this provision in the governor’s budget. Right now the governor recognizes there is a caregiving crisis and all the challenges associated with that. The workforce shortages, the growing elderly population. His budget does deliver on several policy recommendations.”
Across the aisle and in the other legislative chamber Senator Roth agrees that adjusting the rates is necessary.
Sen. Roger Roth, (R) Appleton, said, “There’s no question about it, it’s more expensive in 2021 than it was in 2011 so I think that there needs to be an increase to that, they’re looking for a modest increase.”
He continued and said, “Due to some good budget over the last several sessions and the fact that we’ve got billions, literally billions coming to the state of Wisconsin in federal dollars there’s a real opportunity to raise those Medicaid rates for those home health care workers and that’s something I look forward to working on.”
Non-medical home care providers also have Medicaid clients and they say the reimbursements affect their clients too.
Matt Thompson, the Director of Client Care for Visiting Angels, Appleton said, “Those Medicaid dollars through the family care program directly impact the wages that we can pay our caregivers to care for that person.”
Legislators have two and a half months to address this issue until the 2021- 2023 budget starts on July 1st.
Limited Workforce Leads to Limited Care Capacity
Wisconsin Home Health Agencies Struggle After 10 Years of Stagnant Rates
Wisconsin’s home health care agencies provide high quality, cost effective skilled nursing care for individuals recently discharged from a hospital or skilled nursing facilities. Operating in rural and urban communities throughout the state, home health care agencies provide health care services including skilled nursing, physical therapy, occupational therapy, speech therapy and home health aide in a patient’s home. Home health care services address a variety of health issues, from pulmonary care and neurological rehabilitation to intravenous therapy, wound care, and chronic disease management.
This convenient quality healthcare is also cost effective and reduces the financial burden for patients, private insurance, and public payers. In fact, when home health is the first option utilized after discharge from a hospital, studies found a cost savings of $5,411 per person among the Medicare population. Additional data shows home health care services lead to 26% fewer acute care hospital admissions and 19-30% in total medical cost savings.
Unfortunately, the skilled home health care industry is facing a workforce shortage crisis, which is threatening patient access to care.
Wisconsin’s home health care agencies are reimbursed by private pay insurance, Medicare, and Medicaid. However, Wisconsin’s Medicaid reimbursement rate for home health services has been stagnant for over a decade, without a single increase. Yet over that same time, healthcare inflation has grown 32.3%, and the average Medicare reimbursement rates have increased by 26%. Medicare rates average $145.00 and Medicaid reimbursement for home health services remain at $85.54 per visit.
Such low Medicaid reimbursement levels create a critical workforce crisis for home health care agencies to retain essential skilled nursing staff and adequately serve Wisconsin’s home health care patients. Wisconsin home health agencies regularly lose highly skilled nurses to other sectors of the healthcare industry, mostly due to inequitable compensation potential.
According to the Wisconsin Center for Nursing, Wisconsin is well below the national average when it comes to RNs working in home health settings. RNs working in home health settings make up just 6% of the total nursing workforce in the state, while nationally that statistic is 13% of the total nursing workforce.
Wisconsin’s lagging Medicaid reimbursement rates not only create workforce challenges, they also negatively impact access to home health care services among the Medicaid population.
In short, Wisconsin’s home health care agencies have earned and deserve a Medicaid rate increase. Most importantly, Medicaid patients should be able to access home health services which increase quality of life and decrease medical costs.
By incentivizing home health care agencies to accept new Medicaid patients and increase capacity for home health care to attract new workforce, the state could reduce dependency on expensive institutional-care facilities for post-acute care.
On behalf of the patients we serve, the Wisconsin Association for Home Health Care urges the Legislature to include a modest increase in the 2021-23 biennial budget. It is time to raise Medicaid reimbursement rates for home health care services. The downstream cost savings far exceed the investment and most importantly it will benefit all patients.
Lisa Kirker, RN, MSN, MBA
Wisconsin Association for Home Health Care