OIG says Medicare home health still accessible

Access to services was the primary concern when the Medicare home health prospective payment system (PPS) was implemented last year. But so far that does not appear to be a problem, according to the Health and Human Services Office of Inspector General (OIG), which recently weighed in on this area.

The agency looked at Medicare home health beneficiaries, known as "community" home health beneficiaries, who begin receiving these services without first having been discharged from an acute care facility.

The OIG says these patients appear to have access to Medicare home health care. But it adds that concerns surfaced regarding barriers for Medicare patients with certain medical conditions, confusion regarding Medicare eligibility, and coverage, as well as home health agency staffing shortages.

In most instances, the OIG says it found the reported experiences of community beneficiaries to be similar to those discharged from the hospital into home health services.

The OIG estimated that roughly 40% of Medicare home health beneficiaries do not have a prior hospital or nursing home stay. According to the OIG, there is some evidence that this patient population has more chronic conditions than hospital-
discharge patients.