U.S. Senator Susan Collins recently introduced bipartisan legislation, that she wrote, to preserve home health care by preventing cuts to Medicare reimbursement rates. Senator Collins is a long-time champion of home health care and has worked to ensure that it remains a viable option for our nation’s seniors. In addition, Senator Collins was joined by more than 60 of her colleagues in calling on the Senate Finance Committee to reject additional cuts that were proposed as part of a recent House bill.
“Home care provides compassionate care that has helped keep families together and has enabled millions of our most frail and vulnerable older persons to avoid hospitals and nursing homes and stay they just where they want to be—in the comfort and security of their own homes. And by helping these individuals to avoid more costly institutional care, we are actually saving Medicare millions of dollars each year,” said Senator Collins, who has visited with dozens of Maine home health care providers and has seen first hand the benefits of home care.
At issue are proposed Medicare cuts to home health care that could threaten the availability of such care to seniors in Maine and throughout the nation. The first of which is a Centers for Medicare and Medicaid Services (CMS) proposal to cut home health spending by more than $6 billion over the next 5 years beginning January 1, 2008.
The administrative cuts proposed by CMS are based on the assertion that some home health agencies have intentionally “gamed” the system by claiming that their patients have more complicated and serious conditions than they actually have in order to receive higher Medicare payments. Senator Collins argues that the kinds of across-the-board cuts proposed are unfair and that, if an individual home health agency is truly gaming the system, CMS should target that one agency, not penalize everyone.
Senator Collins also points out that there are very good reasons why the average clinical severity of home care patients’ health may have increased over the years. For example, the incentives built into the Medicare reimbursement system for hospitals have led to the faster discharge of sicker patients. Advances in technology and changes in medical practice have also enabled home health agencies to treat more complicated medical conditions that earlier could only be treated in hospitals, nursing homes, or inpatient rehabilitation facilities.
“This extraordinary reduction in federal support is completely unwarranted. It undermines, and puts at risk the quality care provided to those who rely on our compassionate expertise to manage their recoveries at home, where they want to be,” said Juliana L’Heureux, Executive Director of CHANS Home Health Care and Hospice, a visiting nurse association in Brunswick. “The burden of providing access to an increasingly aging population in Maine will be challenged if agencies are unable to keep up with the increasing costs of needed technology and the expense of recruiting and retaining caregivers.”
“While the need for home care is increasing, the Centers for Medicare and Medicaid Services has sought to decrease rather than increase Medicare home health funding. CMS has imposed a $6 billion cut on Medicare home health beneficiaries who are, by definition, ill and homebound and cannot fight for themselves. Such cuts are unconscionable and out of touch with reality," said Val J. Halamandaris, President of the National Association for Home Care & Hospice.
According to Andy Carter, President and CEO of the Visiting Nurse Association of America, the cuts fall particularly hard on the ability of non-profit Visiting Nurse Agencies to provide home health care services to those who otherwise would have no where else to turn. “Because of their mission of treating all patients regardless of ability to pay, VNAs frequently sustain operating losses as it is already… The added financial pressure from new Medicare cuts would diminish their capacity to meet community needs,” explained Carter.
The bipartisan “Home Health Care Access Protection Act” will block the administrative cuts proposed by CMS. It is cosponsored by Senators Bob Casey (D-PA), Kit Bond (R-MO), Maria Cantwell (D-WA), Pat Roberts (R-KS), and Jack Reed (D-RI).