Val J. Halamandaris, president of The National Association for Home Care and Hospice (NAHC), issued the following statement regarding the Senate Finance Committee Report on Home Health Services.
Today, the Senate Finance Committee issued a report on its investigation of certain home health companies that provide services to Medicare beneficiaries. In that report, the Senate Finance Committee recommended reforming the payment model employed by Medicare to determine the payment amounts for care. Since 2000, the Medicare payment model has tied the amount of payment to the level of utilization of therapy.
“We commend the Senate Finance Committee for calling for changes to the Medicare payment model. There have been systemic Medicare payment problems since its inception in 2000. Home health care has recommended that Medicare set payment rates based on the nature of the patient rather than the volume of services rendered, therapy or otherwise,” stated Val J. Halamandaris, president of the National Association for Home Care & Hospice. “We have long been concerned that the current model discourages home health agencies from providing the care that was appropriate for the individual patient needs.”
The original payment model in 2000 provided a higher payment rate once the patient received 10 therapy visits during a 60 episode of care. Medicare revised the model in 2008, setting increased payment thresholds at 6, 14, and 20 visits. The change was made because of concerns from Medicare and the home health community that the single 10 visit threshold encouraged underutilization as well as overutilization of therapy. Recently, Medicare proposed additional reforms that modify, but do not remove the impact of therapy visit volume.
The home care community has recommended a series of legislative proposals to reform the home health payment system. These proposals will remove the level and amount of therapy as a determent in payment. This and a broad series of program integrity measures have the full support of the home health community.
“Medicare’s proposed reforms may be viewed as a step in the right direction, but we believe that there are better ways to go than continued reliance on the number of therapy visits for determining the payment amount. We are somewhat concerned with the Medicare proposal that increases payments if the patient receives no therapy, while decreasing payments if they do,” explained Halamandaris. “Patients should get what they medically need, not what a payment model directs. Therapy is an essential service that helps patients return to independence, saving Medicare from higher costs while improving patients’ lives. There should not be incentives to deny patients’ care any more that than we should encourage unnecessary care utilization through a payment model,” Halamandaris noted.
“It especially encouraging to see that the Senate Finance Committee, the Medicare Payment Advisory Commission, and the home care community agree that the payment system should be reformed to be one that is patient-centered and encourages high quality of care and the best possible patient outcomes ,” concluded Halamandaris.
About NAHC
The National Association for Home Care & Hospice (NAHC) is a nonprofit organization that represents the nation’s 33,000 home care and hospice organizations. NAHC also advocates for the more than two million nurses, therapists, aides and other caregivers employed by such organizations to provide in-home services to some 12 million Americans each year who are infirm, chronically ill, disabled and dying. Along with its advocacy, NAHC provides information to help its members provide the highest quality of care and is committed to excellence in every respect. To learn more about NAHC, visit www.nahc.org.
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