We Can Fight Medicare Fraud and Abuse Without Gutting Home Health

According to a recent poll by President Donald Trump’s pollster, voters across the political spectrum overwhelmingly agree that targeting waste, fraud, and abuse in Medicare is key to saving taxpayer dollars. However, targeting fraud does not mean blindly cutting popular Medicare programs. 

A handful of bad actors (and outright criminals) raise costs for participants and put taxpayers on the hook to cover the costs. This has gone on for too long, and the Trump administration is right to address it. In a recent Los Angeles Times op-ed, the Centers for Medicare & Medicaid Services (CMS) Administrator Dr. Mehmet Oz outlined how a few unscrupulous operators in California have been submitting false claims and engaging in blatant fraud in the Medicare system, thereby skewing national reporting data used to set policy and payment rates. As a result, regulators proposed cutting some Medicare benefits to a degree that is downright dangerous for patients.

One example is a plan by CMS to cut payments to Medicare home health providers by an astonishing 9%, totaling a $1.1 billion cut next year.

Home health is one of the nation’s most popular, efficient, and effective Medicare benefits, and for good reason: it provides patient-preferred care by qualified healthcare professionals in the lowest cost care setting – their own homes. Studies show that when patients get timely access to home health, Medicare saves about $1.3 billion each year. Why? Because home health keeps patients out of the hospital. In fact, patients who don’t get home health are 35% more likely to end up back in the hospital, 16% more likely to visit the ER, and 43% more likely to die. That means without home health, our healthcare system would see higher costs, more strain on our hospitals, and worse outcomes for seniors.

Medicare’s proposed $1.1 billion cut could cause a negative cascade of home health agency closures, harming seniors nationwide who rely on this service to recover in their own homes rather than in a hospital or institutional setting such as a nursing home. More than 9 out of 10 voters say that home is the preferred setting for care. 

Moreover, the same poll by President Trump’s pollster, Tony Fabrizio, found that 70% of Americans oppose Medicare home health cuts. In fact, 86% of Trump voters who want the President to block the cuts want him to identify more targeted solutions to effectively block fraudulent activities in the Medicare program, which arbitrary cuts will not do.

Let me be clear: I fully support efforts to rein in out-of-control Medicare spending and eliminate unscrupulous criminals and fraudsters who have drained the system and American taxpayers for far too long. However, we must ensure changes target those isolated areas of real fraud, not punish patients and honest providers, who are doing things right and saving the system money. 

There is simply no reason for a few bad apples to spoil the bunch. Cuts to home health and other vital Medicare programs will only harm patients while allowing abusive providers to continue to operate as normal. Severe Medicare cuts will devastate independent providers, leaving their patients with fewer, if any, care options. 

Further, early evidence shows that the home health community is already experiencing a wave of closures throughout the US, especially in rural communities. As a result, patients are backed up in hospitals and unable to access home care in a timely way, if at all. This is especially concerning for rural America, where most small providers operate.

Already, more than 1,000 home health agencies have closed nationwide since 2019, and Medicare’s own projections show that around 44% of providers will be operating at a loss by 2027. Negative margins drive consolidation and destroy competition. When these providers shut down, especially in rural America, patients suffer. 

There’s a simple, common-sense solution: the administration should put the brakes on its plan to cut Medicare home health payments and focus instead on rooting out the isolated areas of waste, fraud, and abuse that are skewing home health cost data. It’s incumbent on Medicare to clean up fraudulent data, crack down on bad actors, and build a payment structure with an accurate and incentive-based methodology that rewards program cost savings and innovation.

Medicare should avoid the temptation to just cut away at programs to find savings and instead find lasting solutions that punish the bad actors without compromising high-quality senior care at home.

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