Trends, Patterns, and Key Comparisons Related to Medicare Home Health Agency Provider Enrollments

OBJECTIVE

Recently, Federal and State oversight bodies have raised concerns about the rapid expansion of home health agency (HHA) provider enrollments and patterns that may indicate deficiencies in CMS’s provider enrollment oversight. Our preliminary analysis shows notable increases in HHAs in certain States, contrasting with declining home health payments nationwide, and suggests that existing controls, such as moratoriums and prepayment review, may not be applied where needed. This data brief will analyze HHA provider enrollment information, Medicare claims data, and population data from 2015 through 2025 to identify trends, patterns, and geographic differences that may signal weaknesses in the enrollment process. The results will provide CMS and other stakeholders with information needed to assess potential vulnerabilities and consider oversight actions to address emerging risks. The objective will be to identify trends, patterns, and comparative data that indicate potential vulnerabilities in the Medicare HHA provider enrollment process.

TIMELINE