Home health care is one of the most compassionate forms of health care. It allows an individual in need to receive health care in the privacy, and comfort, and security of his or her home, near family, friends and loved ones. In rural communities, it allows people to avoid long, and sometimes difficult, trips to medical facilities or to doctor’s offices, which can be far from home. And it can reduce the need for emergency room visits and nursing home care.
Issues affecting home care and hospice have been a top priority of mine since I was elected to the Senate eleven years ago. The highly skilled services and compassionate care provided by home care professionals has helped to keep families together and enabled millions of our most frail and vulnerable older persons to avoid hospitals and nursing homes and stay just where they want to be — in their own homes. Moreover, by helping these individuals to avoid more costly institutional care, home health care is saving Medicare millions of dollars each year.
That is why I find it so ironic and frustrating that the Medicare home health benefit is once again under attack.
The recent House version of the State Children’s Health Insurance Program (SCHIP) reauthorization bill proposed cutting Medicare home health spending by $2.6 billion over five years. Fortunately, neither the Senate SCHIP bill nor the final version included these cuts, but the debate over funding is expected to surface again later this year.
To make matters worse, the Centers for Medicare and Medicaid Services (CMS) has proposed cutting home health spending by more than $6 billion over the next five years. If allowed to go forward, this will result in deep cuts. This simply is not right, and it certainly is not in the best interest of our nation’s seniors who rely on home care to keep them out of hospitals, nursing homes, and other institutions.
The cuts proposed by CMS are based on the assertion that 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.
In fact, there are very real clinical and policy explanations for why the severity of home care patients’ health conditions may have increased over the years. For example, the incentives built into the Medicare reimbursement system for hospitals have led to the quicker 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.
These administrative cuts are proposed to go into effect on January 1st. This could be devastating to seniors served by home health agencies in Maine and across the nation, particularly given that there is no evidence of intentional “gaming” on the part of home health agencies to warrant such a severe financial penalty.
The fact is that the Medicare home health benefit has already taken a larger hit in spending cuts over the past ten years than any other Medicare benefit. This downward spiral in home health spending began with provisions in the Balanced Budget Act of 1997, which resulted in a 50 percent cut in Medicare home health spending by 2001 – far more than the Congress intended or the Congressional Budget Office projected.
Home health care has consistently proven to be a compassionate and cost-effective alternative to institutional care. Additional deep cuts will be completely counterproductive to our efforts to control overall health care costs. They will also place the quality of home health services at risk, particularly given ever-rising transportation, staffing, and technology costs.
Cuts of this magnitude could leave some providers with no alternative but to reduce the number of home health visits or patient admissions, which would ultimately threaten seniors’ access to care and clinical outcomes.
That is why I am introducing legislation to preserve home health care by preventing cuts to Medicare reimbursement rates. In addition, I was recently joined by more than 60 of my colleagues in calling on the Senate Finance Committee to reject additional cuts proposed by the House bill.
The National Association of Home Care & Hospice recently presented me with its highest honor, the “Mother Theresa Lifetime Achievement Award.” The award is given in recognition of exemplary and continuous service in the cause of caring for others. While I am touched to have received this recognition, I
truly believe our dedicated home health care workers are the ones who deserve credit for the outstanding jobs that they do. I will continue to work with them to ensure that our seniors and disabled Americans have access to the quality home health and hospice services they deserve.
Issues affecting home care and hospice have been a top priority of mine since I was elected to the Senate eleven years ago. The highly skilled services and compassionate care provided by home care professionals has helped to keep families together and enabled millions of our most frail and vulnerable older persons to avoid hospitals and nursing homes and stay just where they want to be — in their own homes. Moreover, by helping these individuals to avoid more costly institutional care, home health care is saving Medicare millions of dollars each year.
That is why I find it so ironic and frustrating that the Medicare home health benefit is once again under attack.
The recent House version of the State Children’s Health Insurance Program (SCHIP) reauthorization bill proposed cutting Medicare home health spending by $2.6 billion over five years. Fortunately, neither the Senate SCHIP bill nor the final version included these cuts, but the debate over funding is expected to surface again later this year.
To make matters worse, the Centers for Medicare and Medicaid Services (CMS) has proposed cutting home health spending by more than $6 billion over the next five years. If allowed to go forward, this will result in deep cuts. This simply is not right, and it certainly is not in the best interest of our nation’s seniors who rely on home care to keep them out of hospitals, nursing homes, and other institutions.
The cuts proposed by CMS are based on the assertion that 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.
In fact, there are very real clinical and policy explanations for why the severity of home care patients’ health conditions may have increased over the years. For example, the incentives built into the Medicare reimbursement system for hospitals have led to the quicker 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.
These administrative cuts are proposed to go into effect on January 1st. This could be devastating to seniors served by home health agencies in Maine and across the nation, particularly given that there is no evidence of intentional “gaming” on the part of home health agencies to warrant such a severe financial penalty.
The fact is that the Medicare home health benefit has already taken a larger hit in spending cuts over the past ten years than any other Medicare benefit. This downward spiral in home health spending began with provisions in the Balanced Budget Act of 1997, which resulted in a 50 percent cut in Medicare home health spending by 2001 – far more than the Congress intended or the Congressional Budget Office projected.
Home health care has consistently proven to be a compassionate and cost-effective alternative to institutional care. Additional deep cuts will be completely counterproductive to our efforts to control overall health care costs. They will also place the quality of home health services at risk, particularly given ever-rising transportation, staffing, and technology costs.
Cuts of this magnitude could leave some providers with no alternative but to reduce the number of home health visits or patient admissions, which would ultimately threaten seniors’ access to care and clinical outcomes.
That is why I am introducing legislation to preserve home health care by preventing cuts to Medicare reimbursement rates. In addition, I was recently joined by more than 60 of my colleagues in calling on the Senate Finance Committee to reject additional cuts proposed by the House bill.
The National Association of Home Care & Hospice recently presented me with its highest honor, the “Mother Theresa Lifetime Achievement Award.” The award is given in recognition of exemplary and continuous service in the cause of caring for others. While I am touched to have received this recognition, I
truly believe our dedicated home health care workers are the ones who deserve credit for the outstanding jobs that they do. I will continue to work with them to ensure that our seniors and disabled Americans have access to the quality home health and hospice services they deserve.
