The Case Against a Medicare Home Health Copayment

At our recent meeting with representatives from our state’s  Congressional delegation, Rey Spadoni, President/CEO of the VNA of Boston made some important remarks on the perils presented to home care patients should the MEDPAC proposal – presented to Congress in March –  for a per episode copayment to be enacted on home health services.  Calling copayments “short-sighted” and “ineffective,  Rey has this to say about the reaction from his staff in the field:

When our nurses, who care for patients in the poorest neighborhoods of Boston, hear about this suggestion… they roll their eyes and tell us that most… most… of their patients will not pay them. They will prioritize paying for their prescriptions, their rent and food before they will pay for home care services. For most of our patients, age 80 and above, they are already spending 30% of their limited incomes on uncovered medical care.

The battle to stop a home care copayment  has been successfully fought by this industry before. But this year, it feels a little different. MEDPAC’s copayment call has been embraced by the Congressional Budget Office; and with talk of major Medicare reform on at least the Tea Party’s agenda, copayments in the name of more “personal responsibility” for health care purchasing may have a new and receptive audience.

Although the President resisted the recommendation in his budget proposal, it is clear that this possible wave of change will need “all hands on deck” to stop.

Return to

Author: Pat Kelleher

Pat Kelleher is Executive Director of the Home Care Alliance of Massachusetts.

2 thoughts on “The Case Against a Medicare Home Health Copayment”

  1. I’m not a nurse, but have been a case manager for elders. I agree that elders will prioritize in favor of food and other necessities and not pay for home care, which will inevitably lead to some of them failing at home and ending up in more expensive institutional care. As a 60+ year old myself, I am appalled at the lack of planning and complete disregard for elders that prompts people to think these services are unnecessary or that elders can just dig deeper into their pockets – many already have holes in those pockets, from stocks having gone downhill or having worked at modest jobs all their lives. We spend billions on helping residents of other countries, but get can’t take care of our own citizens when they are old and can no longer work or take care of themselves???? What have we become?

  2. Thanks for sharing this story.I m really very impress after read this story it is very informatics for us. And anybody can get lot of guidance.Most of the patients are not able to paying for all care but U solve all the problems. I appreciate u.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: