Medicare cuts risk breaking an already struggling home health system | Opinion

Home health care is a lifeline for the most vulnerable citizens and the preferred alternative to costly hospital or nursing home stays. However, a potential cut to Medicare payments for home health services threatens to dismantle this essential support system.

The Centers for Medicare and Medicaid Services (CMS) is proposing a $1.13 billion cut to Medicare home health payments for 2026. Reducing home health funding means fewer caregivers, increased costs and worse patient outcomes, particularly in our state’s more rural communities.

In Idaho, this proposed cut will amount to an 8% reduction in 2026 Medicare home health payments. This is on top of the Idaho Health and Welfare Department’s recent decision to reduce Medicaid reimbursement by 4%. These financial hits will force home health agencies across the state to make difficult decisions around their workforce and service offerings, which could negatively impact both the ability to retain current staffing and the availability of jobs in the region. The loss of even just a handful of positions at each agency risks increasing workloads and burnout for remaining staff who remain dedicated to meeting the needs of their patients.

These decisions are being forced on an industry that already suffers workforce challenges. In many Idaho counties, home health agencies struggle to compete with other care settings able to offer higher salaries or sign-on bonuses; a result of those systems receiving adequate funding and steady increases in Medicare rates. In stark contrast, home health agencies have faced cuts year-over-year, and over the next 10 years, funding is projected to be reduced by an additional $25 billion. This is particularly devastating at a time when a growing number of healthcare workers are turning to work outside the industry, where employers may be more readily able to provide steady wages and benefits.

With fewer staff and potentially reduced service coverage, it is Idahoans who will feel it the most. If implemented, the impact of these cuts could lead to higher hospital admission rates as our seniors are unable to access the level of support required to manage their conditions or recover in their homes. As a result, overall healthcare spending will rise while straining critical resources, including hospital beds, staff time and medical supplies in our state, overwhelming any initial savings secured.

This is evident in Idaho, where 37% of patients referred to home health care after hospitalization did not receive it last year. Nationally, the gap in home health care access caused hospital and nursing home readmission rates to increase by 35%, and mortality rates to rise by 43%.

The stakes are especially high for the thousands of Idahoans in rural parts of our state who depend on home health services to stay in their homes.

Reaching patients in these rural communities requires long drives across vast distances. This travel time adds costs and reduces the number of patients a nurse or therapist can see in a day. Without adequate Medicare funding, agencies may be forced to consolidate locations, reducing services in places that need them most.

Home health care is the most effective and compassionate way to serve many of our neighbors. It is what our patients want, and it is what our healthcare system needs. Idaho cannot afford to lose the vital support provided by these services.

Thankfully, policymakers have already taken steps to protect access to this care, including Reps Kevin Hern, R-Oklahoma, and Terri Sewell, D-Alabama, who recently introduced the Home Health Stabilization Act (H.R. 5142).

Additionally, we have been grateful for the efforts of key figures in the debate, including Idaho’s Sen. Mike Crapo, R-Idaho, chairman of the Senate Finance Committee, whose leadership and recent engagement on this issue have been encouraging. We must continue to build on this momentum and promote policies that ensure our most vulnerable continue to receive the care they deserve in the setting they prefer.

John J. Gochnour is president and COO at Pennant Group, based in Eagle.