Home health deserts are increasing at an alarming rate across some rural states as home health companies close or reduce services due to financial challenges.
Home health companies in Maine, Nebraska and Minnesota say a proposed Medicare rate cut, low Medicare Advantage reimbursements and workforce shortages are forcing them to make difficult business decisions — leaving many communities with limited access or no access to post-acute care in the home. But the Medicare Payment Advisory Commission, which advises Congress, has downplayed access problems in rural areas and said federal reimbursements are adequate to support services there.
Approximately 800 home health providers have closed over the past five years, according to the National Alliance for Care at Home, a trade group that represents the industry. Alliance CEO Dr. Steve Landers mostly blames a Medicare home health payment model that went into effect in 2020 for reducing Medicare reimbursements and causing financial stress for providers.
“While closures are significant, we are also getting reports that providers are restricting the territory they serve as a first step to addressing their financial stresses,” Landers said in an email. “This appears to be especially concerning in rural areas where no other provider is available to step in.”
But providers in some areas are stepping in to fill care voids where they can.
In May, Evangelical Lutheran Good Samaritan Society began offering home-based care in International Falls, Minnesota after the small Canadian border town lost its only home health provider, said president and CEO Nate Schema in an email.
Schema said community leaders asked the Sioux Falls, South Dakota-based nonprofit to step into the vacancy because it had already operated a senior living community in International Falls for six decades. He said Good Samaritan Society obliged because it made a longstanding commitment to the health and well-being of the people who lived there.
“We were proud to be able to step up and expand home health and hospice services to help fill the growing need in the area,” Schema added.