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Medicare home health payments to most freestanding home health agencies more than covered their costs.

costs when their low margins are related to size and location rather than
inefficiency. Two associations stated that the draft report should have addressed
additional issues. VNAA stated that we should analyze how the revenues
generated by positive margins are used by different segments of the home health
industry. AAHomecare raised several questions, including whether skilled
nursing facility (SNF) care is being substituted for home health care.