Home healthcare providers did a better job releasing patients into the community, but at the same time, slightly more patients were admitted to hospitals from home healthcare. Those are the mixed findings from a recent Medicare Payment Advisory Committee (Medpac) report.

Data collected over five years found home healthcare providers improved their discharge rates into the community from 68.3% in 2015 to 72.2% in 2019. But during that same time, the number of patients being admitted to hospitals from home health increased from 20.6% in 2015 to 21.4% in 2019.

MedPAC found hospital-based home health agencies (HHAs), HHAs located in urban areas and nonprofit HHAs generally performed better than their counterparts in rural settings on these measures. 

Loss of HHAs

The report also found the home health industry lost more HHAs between 2019 and 2020 than skilled nursing. The number of HHAs declined 1% during that period compared to 0.9% for skilled nursing. However, that was better than the losses sustained by long-term care hospitals and inpatient rehabilitation facilities, which saw their numbers decline 5.4% and 3.4% respectively.

Florida and Texas accounted for the largest number of HHA losses over that period. But MedPAC pointed out that both states had seen considerable growth since 2000 due to the implementation of the home health prospective payment system.

Costliest beneficiaries

The report found the most costly 25% of Medicare beneficiaries accounted for 84% of total Medicare spending. Those patients suffered from multiple chronic conditions, were dually eligible for Medicare and Medicaid and were in the last year of their lives.