Increasing Medicaid Rates: A Critical Step to Support Home-Based Care

Published 10 hours ago via Business Wire

To address the growing challenges facing the healthcare system, the Homecare and Hospice Association of Utah (HHAU) calls for an urgent increase in Medicaid reimbursement rates for Home and Community-Based Services (HCBS) waivers, Private Duty Nursing (PDN), and Home Health. These critical services form the backbone of home-based care, enabling individuals to receive the medical attention and support they need in their homes, while saving tax dollars and alleviating strain on hospitals and long-term care facilities.

The Current Crisis

Medicaid’s reimbursement rates for home-based services have remained stagnant for five years or longer, failing to keep pace with rising operational costs, workforce shortages, and inflation. Provider staffing costs have increased an average of 20% during the same time. This funding gap puts immense pressure on providers, leading to reduced access to care for Medicaid recipients who rely on home-based services to maintain their quality of life and independence. Many providers have reduced their Medicaid patient census or stopped participating in Medicaid programs altogether due to unsustainable reimbursement. Those providers who remain are struggling to recruit and retain skilled caregivers, resulting in delayed or denied services for some of our most vulnerable populations.

Why Increasing Medicaid Rates Matters

Increasing Medicaid reimbursement rates is essential to:

  1. Ensure Continuity of Care: Adequate funding enables providers to maintain essential services for children and adults with complex medical needs, allowing them to live safely and comfortably in their own homes.
  2. Address Workforce Shortages: Competitive wages are critical to attracting and retaining qualified caregivers, nurses, and therapists, ensuring a stable and skilled workforce.
  3. Reduce Healthcare Costs: Home-based care is almost invariably much more cost-effective than institutional care, providing significant savings to the healthcare system and taxpayers while delivering personalized and compassionate care.
  4. Support Family Caregivers: Families of individuals receiving Medicaid-funded services often rely on professional caregivers to provide relief and maintain balance in their lives. Enhanced funding helps sustain this vital support network.

Voices from the Community

“Increasing Medicaid rates for home-based care is not just an investment in healthcare; it’s an investment in dignity and independence,” said Braxton Nerdin, Director of Business Operations with Maxim Healthcare Services. “Without adequate reimbursement, we risk losing the critical infrastructure that allows individuals, including medically fragile Utah children with special needs to receive care where they thrive the most: at home.”

We know access to these services makes a difference for more than the child, but for the entire family and community. A single-mom using the PDN system was recently able to return to work full-time and avoid eviction from the child’s home. That care is now in jeopardy due to low Medicaid reimbursement rates.

Call to Action

We urge lawmakers, healthcare advocates, and community members to join us in supporting urgent Medicaid reimbursement rate increases for HCBS waivers, PDN, and home health during the upcoming 2025 Legislative Session. Please support the recommendations of Governor Cox, the Medicaid Advisory Committee, and the Department of Health and Human Services, to sustain home-based programs through increased reimbursement rates. Together, we can ensure that our most vulnerable neighbors have access to the care they deserve while fostering a sustainable and resilient healthcare system.

About the Homecare and Hospice Association of Utah

HHAU's mission is to protect people's rights and access to care by supporting and promoting Utah's home-based health, hospice, and personal care industries. We do this through our four pillars of Education, Advocacy, Partnership, and Public Outreach.

The Association is led by a volunteer Board composed of representatives from many of Utah's homecare and hospice providers in addition to valued community partners from parallel industries.

Contacts