Situation Report | November 2, 2020
Seventy-seven home care, hospice and Managed Long Term Care members completed an HCA statewide survey last month designed to learn more about your experiences in the pandemic and economic fallout. Thank you.
This was our third survey in the pandemic and, like the earlier two, it is already helping to drive key messaging in support of our advocacy.
As you may have seen from last week’s monthly Capitol Report newsletter for state lawmakers, HCA previewed some of the survey findings, maximizing an opportunity to report fresh information on the workforce, financial and consumer access stresses that home care, hospice and Managed Long Term Care face.
- The overwhelming number of agencies (85%) said that structural workforce shortages — especially the limited numbers of nurses, home health aides (HHAs) and/or personal care aides (PCAs) — have been greatly amplified by COVID-19, and these shortages are a primary obstacle to admitting patients, including for persons needing to be discharged from the hospital.
- Approximately 43% to 45% of home care and hospice agencies have experienced a decrease of 11% or more in HHA and PCA workforce capacity since March 7, 2020.
- 65% of home care agencies in New York State saw an increase in referrals to home care from hospitals and other settings since the onset of the public health emergency. Yet, alarmingly, 76% of agencies have reported challenges in accepting these new referrals, mostly because of reduced workforce availability.
- Even now, well after the springtime coronavirus surge, most organizations (63%) have not fully recovered their normal patient counts (i.e., census), with 42% of providers remaining “somewhat below” and 21% still “substantially below” pre-pandemic census levels. Half of providers experienced an overall decline of 10% or more in their patient census since the start of New York’s public health emergency.
- Home care and hospice financial viability also remains a critical concern, with almost all providers (94%) projecting a financial loss due to COVID-19. A plurality (40%) expect losses of 11% to 20%, with some reporting even higher impacts.
These are powerful data points that we will be exploring further in all facets of our advocacy messaging to support you.
In addition, members who saw last week’s HCA Legislative Action Center campaign on the Home Health Emergency Access to Telehealth (HEAT) Act may have also noticed another key data point, also culled from our provider survey:
- The number of home health providers having to turn to telehealth in the pandemic has doubled — from 22% of providers before the pandemic to 46% today.
While telehealth use has rightly increased in the pandemic, it remains unreimbursed by Medicare and uncapitalized for Medicaid home care, hospice or MLTC, and this payment dilemma is clearly making it difficult for providers to implement telehealth: of those providers who still aren’t using telehealth, most say it’s because of payment reasons, according to HCA’s survey.
This data helps reinforce our advocacy by substantiating the need for legislation like the HEAT Act, which would provide Medicare reimbursement to home health agencies that deliver audio and video telehealth services during COVID-19 — a major priority.
More Details Coming Soon
Your survey answers are also helping HCA prioritize what areas to focus on in our membership support, education and advocacy efforts. We will soon provide a more formal presentation of these results, what they mean, and how they can further help support you.
In the meantime, we thank you for participating in our survey and want you to see the enormous value it provides in strengthening our work for you.