California Doubled Its Share of Medicare Home Health
CMS posted the CY2025 home health utilization file on September 1, the same claims year it is using to set CY2027 rates. Across all 55 jurisdictions, California is the only one sending more visits per patient than it did in 2017, and it now books 22.9% of the program on 14.6% of the patients. Here is what the proposed 3% cut takes out of each state.
If you run a home health agency anywhere except California, the file CMS put up on Tuesday is about you.
It is six columns wide. State, reimbursement, patients, visits, and two averages.
CMS refreshed Medicare Home Health Patients and Visits by State on September 1 with the CY2025 year, and CY2025 is the same claims year the CY2027 proposed rule says it is pricing off: "we are using CY 2025 claims data for CY 2027 payment rate updates."
So the arithmetic sitting in this file is the arithmetic behind next year's base rate.
Nationally the program has been contracting for eight straight years. Patients went from 3,432,475 in CY2017 to 2,670,830 in CY2025.
Visits fell harder, 106.5 million down to 65.7 million, a 38.3% drop.
Medicare now pays $250.11 a visit against $170.08 in 2017, and buys 24.61 visits per patient instead of 31.04.
Fifty-four jurisdictions moved that way. One went the other direction (chart below).
The rest of this brief is for subscribers.
The impact tables, the code-level detail, and the rest of the analysis sit past this line.
$50 a month, or $500 a year.
Already a subscriber? Sign in