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.