Medicare home health services play an essential role in helping older adults manage chronic conditions, recover from surgeries, and transition from hospitals back to the comfort and familiarity of their own homes. Across Massachusetts, over 100,000 people depend on the Medicare home health benefit to access these specialized care services. But in yet another round of cuts to Medicare’s home health benefit, this critical care system is at risk, jeopardizing access for some of our state’s oldest and sickest patients.

Home health services offer an array of care from skilled nursing to physical and occupational therapy and support from home health aides to medical social workers, all of whom deliver personalized care that is individually tailored to each patient’s needs. Despite the clear benefits and growing demand for home-based care – with most Americans wanting to age and receive care in their own home – Medicare has proposed yet another cut to home health payment rates for 2025. The proposed -4.067% cut marks the third consecutive year of steep reductions, and it comes at a time when the need for home health services is increasingly higher.

Medicare cuts persist despite opposition from those in the home health community, patient groups, hospitals, and lawmakers on both sides of the aisle. And the impact of these cuts on Massachusetts’ older population is profound. According to recent data from the Massachusetts Health & Hospital Association (MHA), the number of patients awaiting hospital discharge into home health services is steadily increasing, and reached more than 640 patients in June 2024 alone. Within our state, more than 85% of home health patients are also dealing with multiple chronic conditions that require specialized care, so delayed access to home health services often results in extended hospital stays, increased healthcare costs, and a greatly diminished quality-of-life.

Moreover, the proposed cuts are threatening the very existence of home health agencies in our state. The MHA report also highlights ongoing challenges faced by home health providers including staffing shortages, increased operational costs, and a lack of adequate reimbursement for services. When agencies are able to stay open, many home health providers are being forced to shrink their service areas drastically, leading to few options for seniors in rural or underserved areas.

If these cuts continue, as Medicare has proposed for 2025, we can expect to see additional agency closures and broader service area reductions, further limiting access to home health services and placing even more strain on our already overburdened healthcare system.

The impact these cuts will have on home health employees cannot be overlooked. The home health sector in Massachusetts creates more than 57,000 jobs, ranging from direct care professionals to administrative staff. These roles ensure the delivery of necessary care to our older population, but the reimbursement levels simply aren’t enough to cover rising costs, particularly as they try to compete with other industries across the state to attract talent. In Massachusetts, where most jobs pay above minimum wage, home health agencies are struggling to keep up and are losing workers to retail, food service, hospitals and other industries that can offer better pay. When positions from home health aide to clinician are left empty, we are limited in our ability to accept patients, further exacerbating this crisis.

It is time for Congress to act by putting a stop to these cuts and protecting the Medicare home health benefit.

The bipartisan Preserving Access to Home Health Act (S. 2137/H.R. 5159) is a vital piece of federal legislation that would prevent Medicare from implementing more cuts to the Medicare Home Health Benefit in 2025 and beyond. This legislation would be a huge step in protecting Medicare beneficiaries across the state who rely on this benefit to receive quality care in the comfort and safety of their own home.

I commend Massachusetts Representatives Lori Trahan and Stephen Lynch for being cosponsors of the Preserving Access to Home Health Act. I strongly urge Senators Elizabeth Warren and Ed Markey, as well as the remaining Massachusetts delegation in the U.S. House, to support and cosponsor this important bill. The stakes are simply too high for our seniors, our healthcare system, and our economy.

Jake Krilovich is the Executive Director of the Home Care Alliance of Massachusetts.