Ohio Home Care Advocates Look to Boost Outdated Medicare Reimbursements

Home care will be 'untenable' without a rate increase, says chair of the Ohio Council for Home Care and Hospice.

With Medicare reimbursement rates no longer covering the cost of care and preventing agencies from paying competitive wages, the Ohio Council for Home Care and Hospice(OCHCH) is seeking rate increases.

Medicaid reimbursement rates are the same as they were in 2000—despite inflation rising more than 75%, according to Lisa Von Lehmden-Zidek, Cleveland-based chair of the OCHCH board.

"The cost of home care greatly exceeds what Medicaid covers, and it makes no sense because receiving home care is significantly less costly than institutional care," she said in a statement. "If this continues, home care will be untenable and the costs for all Ohioans will increase with institutional care and more hospitalizations."

Lack of adequate pay for caregivers adds to the ongoing healthcare workforce shortage, which has many home health agencies struggling to hire staff, no longer accepting Medicaid patients, or closing their doors completely. In Ohio,  patients in underserved and rural areas have been affected the most.

"Within the next two decades, the population of those 60 and older is expected to grow more than four times faster than the state's overall population," Joe Russell, executive director of the OCHCH, said in a statement. "If we want to care for the influx of older adults to allow them to age in place, and to help others who are struggling with disabilities, chronic illnesses or recovering from surgery, we need to address the worker shortage and cover the costs of these services."

Founder and co-owner of Patriot at Home, a home health provider, Greg Davis said his agency loses $800 per patient when they admit a Medicaid patient. Over two years, he added, they've lost hundreds of thousands of dollars providing care to Medicaid patients.

Because there aren't enough providers to meet the demand for home health services, many state residents have been added to waiting lists where they're having to wait up to two years for services. As a result, they're forced to deal with inadequate care, depending on emergency rooms or nursing homes, which are often more expensive.

The state's home health issues can be addressed in its biennial budget, Russell said. Currently, advocates want to increase wages to $35 per hour for RNs  and $20 for aides, which would also help cover overhead costs.

"We should value the health and safety of Ohio's most vulnerable in a way that's on par with Medicare and private pay. Ohio Medicare payments can be more than 300% what Ohio Medicaid pays for the exact same service," Russell said. "Our goal is for state Medicaid reimbursements to cover the actual costs for care."