CHILLICOTHE, Ohio — Recent developments in Medicare payment policies have prompted discussions among healthcare providers in Ohio regarding the potential impact on home health services.
Medicare Payment Updates for 2025
The Centers for Medicare & Medicaid Services (CMS) recently announced updates to the Medicare home health payment system for 2025. These changes include an aggregate increase of 0.5% in Medicare payments to home health agencies compared to the previous year. However, this increase is offset by reductions, including a 1.975% permanent prospective adjustment to account for the impact of the Patient-Driven Groupings Model (PDGM), as well as other behavioral and fixed-dollar loss ratio adjustments.
While the payment updates include an increase in the base payment rate, the reductions are causing concern among home health agencies regarding their ability to meet rising operational costs.
Implications for Ohio’s Home Health Agencies
Despite the modest net increase in payments, the permanent and behavioral adjustments are viewed as reductions that could affect the financial stability of home health agencies. Providers in Ohio are evaluating how these changes will impact their ability to deliver essential care to elderly and chronically ill patients.
There are also growing concerns about Medicare Advantage plans, which reportedly reimburse home health services at lower rates compared to traditional Medicare. This disparity may create additional challenges for agencies already grappling with financial constraints, potentially limiting access to care for beneficiaries enrolled in Medicare Advantage.
Call for Stakeholder Engagement
Healthcare leaders in Ohio are engaging with policymakers to address the potential challenges posed by these adjustments. They are advocating for reimbursement rates that accurately reflect the costs of providing home health services, ensuring continued access to care for Medicare beneficiaries across the state.
As these policy changes come into effect, collaboration between home health agencies, Medicare Advantage organizations, and federal officials will be vital to mitigate challenges and support the sustainability of home health services in Ohio.