It's like having your ice cream taken away after the first bite.
That's the frustration home health providers are feeling.
On July 1, HCFA raised Medicare payment rates to home-care providers by 3%. But the federal budget bills passed by the House and Senate last month would repeal that increase on Oct. 1 and seek an extra $1 billion in savings from Medicare payments to home-care providers in fiscal 1998.
Medicare pays home-care providers on a per-visit basis. The rates depend on the type of home-care service given and are capped at 112% of the national average rate per visit of those particular services.
HCFA raised the per-visit fee cap by about 3% across the board, effective July 1 (See chart). Medicare is projected to spend $19 billion on home-care services for beneficiaries in fiscal 1997, which ends Sept. 30.
The size of the rate increases was not unexpected, said Karen Pace, vice president for research and regulatory affairs at the National Association for Home Care.
But because Congress' pending balanced-budget plans seek to generate nearly $116 billion in Medicare savings between fiscal 1998 and 2002, Pace said home-care providers shouldn't expect their wallets to get fatter. Of that $116 billion, nearly $16 billion is to be extracted from Medicare home-care expenditures.
"It's not really an increase the agencies can count on," she said.
Specifically, the plans pending in Congress would reduce the per-visit cap to 105% of the national average fee from 112% starting Oct. 1. That move alone would save Medicare $2.9 billion in fiscal 1998 and 1999, the Congressional Budget Office says.
The budget plans also call for the development of a prospective payment system for home care.