Hospice and home care - often used by seniors and those recovering at home - may be subject to the hardest hits from the Affordable Care Act, also known as "Obamacare." The National Association for Home Care & Hospice (NAHC) estimated that by 2017, nearly three-quarters of these specialized care centers will be operating at a loss.
"Medicare payment rate cuts will make the industry unstable," Bill Dombi, vice president at the NAHC, told The Christian Post in an interview this week. "By 2017, 72.9 percent of all home health will be paid less than the cost of care," he predicted, based off of data from 2011 and 2012.
Due to Obamacare cuts in Medicare, hospice and home care providers will receive less reimbursement and fewer seniors will be able to use the program, Dombi explained. "We just basically got straight Medicare cuts," he explained, referring to the home health industry. "Home Health has a huge rate cut – the maximum cut that the law committed."
Dombi cited the Centers for Medicare and Medicaid Services (CMS), which admitted that 43 percent of providers will be paid less than cost. CMS estimated that many of the providers already operate at a loss and so can continue to do so. "That position is illogical," Dombi declared, arguing that "the longer a business is in the red, the more likely it will close."
According to the NAHC report, only three states will escape negative Medicare margins in the home health sector – Tennessee, Georgia, and Connecticut. Other states range from small losses, such as Rhode Island (0.2 percent) and Alabama (0.3 percent), to much more significant losses, like Alaska (48.3 percent), North Dakota (38.8 percent), and New York (36.3 percent).
"The factors that influence the cost per visit include staff productivity, staff travel time, and overhead costs," Dombi explained. "In a densely populated state, staff may have only short travel distances between patients while in states like North Dakota and Alaska it may take 1-2 hours to travel between patients."
Robert Moffit, senior fellow at the Heritage Foundation's Center for Health Policy Studies, explained that Obamacare has long been predicted to cut hospice services by $17 billion. "This is the report delivered on July 24, 2012, by the Congressional Budget Office," Moffit explained. "There's no excuse for people being surprised by any of this."
"A lot of these savings are going to be used to pay for the Obamacare expansions through Medicaid and the subsidy program," Moffit said, pointing to a "shift of funding from Medicare to the entitlement expansions in Obamacare." In a report from May 2013, Moffit totaled the Medicare cuts due to ObamaCare – the number came to $716 billion.
"One thing is certain: Under the Obama agenda, seniors will pay more – much more – and they will pay this steep price in many different ways, including a loss of access to care resulting from demoralized doctors and other medical professionals cutting back on Medicare practice," Moffit wrote.
The Center for American Progress, a long-time supporter of the Affordable Care Act, did not return requests for comment by press time.