NAHC to Congress: Do Not Resurrect Medicare Home Care Copays

Changes to Medicare’s benefit design currently being considered by the House Ways and Means Subcommittee on Health, such as cost sharing for home health and hospice care services, have been denounced by the National Association for Home Care and Hospice (NAHC). 

The House Subcommittee held a hearing on Tuesday focusing on cost-sharing changes to the Medicare program, and NAHC submitted written testimony objecting to shifting costs onto Medicare beneficiaries on the grounds that it might prevent some from receiving the care they require.

If beneficiaries have to share more costs for home health and hospice care, some may forego treatment on affordability grounds, and it could prompt an unnecessary move into an institutional long-term care setting, says NAHC. 


“Congress eliminated the home health copayment in 1972 for the very reasons it should not be resurrected now. The home health copayment in the 1960s and 1970s deterred Medicare beneficiaries from accessing home health care and instead created an incentive for more expensive institutional care,” the testimony says. “Reinstating the home health copay today would undo the progress made in efforts to reduce unnecessary hospitalizations and nursing home stays.”

As the health system seeks to make acute and post-acute care delivery more efficient, rehospitalizations that could have be prevented with adequate home health care could rise. The testimony cited Avalere analysis finding that a home health copayment could increase Medicare inpatient hospital spending by $6-13 billion in a ten-year span.

“Care in the home means that the Medicare beneficiary provides all the financial support in terms of room and board that are otherwise paid for by Medicare and Medicaid in an institutional setting,” the testimony says. 


Instead of cost-sharing, NAHC offered several proposals to strengthen the Medicare program’s integrity and to expand the use of home care and hospice to deliver high-quality care at a lower cost to Medicare. 

View the testimony here.

Written by Alyssa Gerace

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