A Maine home health care worker told members of a U.S. Senate committee Wednesday that recent Medicare reimbursement reductions have limited providers' ability to care for patients in rural communities.
LeighAnn Howard, of Home Health and Specialty Programs for Northern Light Home Care & Hospice, said home care capacity in Maine has shrunk while costs are increasing due to a shortage of qualified caregivers. Howard said that's forcing health care providers to make tough decisions.
"We have to send staff out to a patient that's two hours away - can we even do that when we have three other patients that are in a more tight geography?" Howard said. "Do we go serve that one patient or do we stay closer and serve those three?"
Howard said funding cuts are curbing home care providers' ability to maintain support services and skilled care - and to even reach patients.
"For example, to serve many of our island communities off the coast of Maine, our clinicians need to travel by lobster boat or mail boat, as this is the only way to access the island," she told members of the Senate Aging Committee at a public hearing.
Some providers also took issue with a rule that allows only physicians to certify Medicare-funded home health care, even though many patients rely on physician assistants, nurse practitioners and clinical nurse specialists as primary health providers.
The committee's chair, Maine U.S. Sen. Susan Collins, has proposed a measure called the Home Health Care Planning Improvement Act that would change that by removing the physician restriction. In an emailed statement Collins' spokesperson Christopher Knight says the Senator also introduced the Home Health Payment Innovation Act, which is focused on Medicare reimbursement.
"S. 433 restores stability to home health provider payments as they transition to a new payment system by requiring CMS to base Medicare reimbursement rates on observed evidence and data, and not on assumed behavioral changes," says Knight.
Meanwhile, President Donald Trump has proposed a budget that would cut Medicare by another $451 billion.
Updated with added statement from Collins' office 5:05 p.m. Feb. 12, 2020.