Workers shortages stay an issue in house care. Whereas that’s true, total employment in house well being care is definitely greater now than it was earlier than the COVID-19 pandemic.

That's in keeping with the Medicare Fee Advisory Fee (MedPAC), which launched its March 2024 report back to Congress on Friday. Along with together with data on house care employment, the MedPAC report as soon as once more urged Congress to cut back the fee-for-service (FFS) for Medicare house care funds.

MedPAC has repeatedly argued that Residence Well being Company (HHA) margins are too excessive and that well being care suppliers are typically overpaid.

“The Fee's investigation reveals that FFS Medicare funds for house well being care considerably exceed prices,” the March report stated. “Residence care generally is a high-value profit if delivered appropriately and effectively, however these extra funds scale back that worth.”

Employment prospects

Residence well being care organizations within the U.S. have skilled staffing shortages throughout a number of features.

Rising demand for house care companies has partly contributed to the issue. Many studies have additionally highlighted how house care staff have left their jobs for different professions – or withdrawn from healthcare altogether.

However total employment charges in July 2023 have been about 5% greater than earlier than the pandemic, in keeping with Commerce Division information on the broader medical house care trade. Nevertheless, you will need to observe that the medical house care trade additionally consists of hospices, non-public nursing, pediatric house care businesses, and extra.

“Though these information measure employment for a broader class of house well being companies than Medicare HHAs, the latter embrace a good portion of this sector,” MedPAC wrote in its report.

MedPAC notes that studies of house care workforce shortages might solely “replicate native labor market circumstances” or “different elements not noticed in nationwide workforce measures.”

MedPAC fee suggestion

In the case of decreasing house well being care funds, MedPAC is urging Congress to chop Medicare base fee charges by 7% by 2025.

This suggestion comes regardless of MedPAC recognizing how the prices of offering house well being care companies have elevated.

“2022 noticed a 4% enhance in prices per 30-day interval for freestanding HHAs, a reversal of the pattern for 2021, once we noticed prices per interval decline 2.9%,” MedPAC wrote in its report .

Broadly talking, MedPAC believes house well being businesses can stand up to the fee cuts as a result of their margins stay excessive. Stakeholders within the house care trade have usually disputed this declare, describing it as an inaccurate and flawed calculation.

Laws has even been launched to alter the best way MedPAC appears at well being margins domestically.

Along with the cuts and employment prospects within the sector, MedPAC highlighted how house care use is declining.

In keeping with MedPAC, 30-day house care quantity in FFS Medicare declined 7.5% in 2022.

That decline is probably going associated to elevated enrollment amongst beneficiaries within the Medicare Benefit program. Additionally it is seemingly associated to expert nursing facility (SNF) utilization returning to pre-pandemic ranges.

“Earlier than the pandemic, SNFs have been the commonest first vacation spot for post-acute care (PAC) amongst beneficiaries receiving formal PAC, with house well being companies being the second most typical PAC vacation spot,” the report stated. “In 2020, the 2 companies switched ranks of their share of use after a hospital keep. Residence care companies turned the commonest preliminary PAC service; the proportion receiving SNF companies decreased to the second most typical first PAC service. Nevertheless, since 2020, the share hole between the 2 companies has narrowed.”