I think Medicare needs to look at the larger picture. It is being penny wise and pound foolish. Home Health Care has been demonstrated over and over again to save patient lives and money in the long term.
There is a huge influx of aging baby boomers coming down the pipeline, and any knee jerk reaction to save a few dollars in the short term will have profound unintended but disastrous consequences in the future. After gutting the capacity of existing providers and muddling the processes involved, what we will end up with is fewer providers, but a boom in the number of patients, who will be utilizing hospital emergency rooms at significantly higher rates than present because of the glut in providers.
What Medicare needs to do right now is to streamline home health care, by fortifying the existing providers and rewarding them for good out comes, instead of punishing existing providers. The current relationship model that Medicare has developed with home health providers is adversarial. Healthcare has been criminalized in the Unites States, and all providers are considered criminals until proven innocent, often by following very complicated rules meant to trap providers into breaking them. Until Medicare stops seeing home health care as a problem, rather than as a solution to a problem that is only beginning to creep up, we will continue to see conflicting laws and rules that do not make any sense.
The objective is to save lives and money down the road, but the path Medicare or the government has chosen at present is extremely short sighted, because it is intended to destroy home health care as an industry altogether.