CMS sets Medicaid payments to home care workers at 80%

The Centers for Medicare & Medicaid Services (CMS) is hoping to improve Medicaid enrollees’ access to care through a final rule that better compensates caregiving roles.

Under the final rule, at least 80% of Medicaid payments for home care services will go toward wages, according to a White House news release that included a controversial nursing home staffing rule.

It also permits states to factor in the “unique experiences that small home care providers and providers in rural areas face.”

The administration cited a study from the Commonwealth Fund showing that higher wages will reduce turnover and lead to better care for seniors and individuals with disabilities.

Additionally, states will be required to declare how much they pay for home care services and how they set rates. Wait times, waiting lists and quality measures should all be tracked. They must also create a home care rate-setting advisory group including beneficiaries and workers to consult on future payment rates.

Aging services provider LeadingAge criticized the details released so far, saying they are concerned about Biden’s final rules Monday.

“On the Medicaid access rule, the lack of infrastructure for collecting and reporting out accurate information, of financing to support added resource needs, and of data to ensure that the dollars being distributed as intended, will decrease access to care,” said Katie Smith Sloan, LeadingAge president and CEO. “What’s more, given these shortcomings, there is no guarantee that this rule will increase worker compensation.”

The National Association for Home Care & Hospice said the rule makes it more likely for providers to close, the association told Home Health Care News.

CMS’ Medicaid managed care rule requires states to enforce wait time standards through secret shopper surveys. A quality rating system will be developed for beneficiaries to compare plans.