Tag: Medicare

CNN Story Highlights Impact of Possible Home Health Cuts

A proposal in the US House of Representatives, known as the “Tri-Committee” Health Reform Bill, would take $56.8 billion over ten years from the Medicare home health payment, according to the Congressional Budget Office (CBO) and the National Association for Home Care & Hospice (NAHC).

CNN reported on a 12 year old California girl getting care from a team of home health professionals. The story highlights how that care is threatened by potential cuts in the Tri-Committee bill.

Click here to read the CNN story and please visit our “contact your legislator” page to send a message to your federal representatives in an effort to oppose cuts to home health. Just fill in your contact information and click “send” to deliver the message.

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New Medicare Website Launched to Help Caregivers

A new website called “Ask Medicare” was recently launched as a resource and navigation tool for the millions of caregivers so that answers and information can be readily obtained for those who give much of their time caring for others.

Many features are available on the site, including help with billing, comparing drug plans, locating care, and even a chat room for caregivers to exchange their stories and experiences.

CNN did a report on the new website, which you can see by clicking here. The article focuses on Kim Mickens, a Baltimore woman who spends 40 hours per week caring for her mother Delphine who lives with Alzheimer’s disease.  Below a a brief clip from the CNN story:

Today, Mickens and her mother are a loving twosome. When Mickens is at work, she leaves Delphine with an in-home nurse and relies on her son to help out when he gets home from school. Mickens finally feels content about the quality of care her mother is getting, and she says it would have never happened so quickly had she not found the Ask Medicare Web site.

“I have no problems with it: Once I punch it in, it comes up and takes me out to all the different Web sites,” say Mickens. “It’s very helpful. I am glad they came up with it.”

Click here to visit the newly-launched “Ask Medicare” web tool for caregivers.

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CMS Proposes 2010 Medicare Home Health Rates

On Thursday, July 30, CMS posted proposed changes to the Medicare home health payment rates for calendar year 2010. Under the propose changes, the national standard episode rate for home health services will see a net increase of 2%, from the current $2,271.92 to $2,317.47.

The new rules also update the wage index for each metropolitan and rural area. For Massachusetts, the indexes for Barnstable and Springfield are going down slightly. All other regions will see a small increase.

The Alliance has prepared a spreadsheet of 2010 rates based on the CMS proposal.

**Note that these rates are subject to change if Congress passes a healthcare reform bill this year.**

Congressman Barney Frank Responds to Alliance Letter

The Alliance recently received a response from the office of Massachusetts Congressman Barney Frank after Home Care Alliance Executive Director Patricia Kelleher urged him to sign onto two home health initiatives:  One was a letter opposing damaging cuts to home health and the other asked that he sign on to the Home Health Working Group.

Both of those initiatives were led by Frank’s colleague, Congressman Jim McGovern. The Alliance appreciates the response and the support that Congressman Frank offered.  Click here to see the sign-on letter opposing cuts to home health, along with the supporting signatures from members of Congress.

See the Alliance’s letter sent to Congressman Frank below, which was sent to the entire state’s Congressional Delegation in late April, and click here to see Frank’s response.

Dear Congressman Frank:

On behalf of Home Care Alliance of Massachusetts, I urge you to sign on to a pair of initiatives championed by your colleagues James McGovern and Walter Jones that opposes home health care cuts in the President’s budget and establishes a House Home Health Working Group.

Home-based services promote independent living for seniors and other individuals in need of care, which help them to remain in their communities where they are most comfortable and familiar. These services are cost-effective in keeping patients out of the hospital and nursing homes. At an economically challenging juncture when home health rates are being frozen and reduced in Massachusetts on the state level, we need to encourage and expand the utilization of home-based care rather than make damaging cuts.

The Working Group will look to further the role of home health in our nation’s health care delivery system while the McGovern-Jones “dear colleague” letter – addressed to the Committee on Ways & Means – resists the President’s proposal to cut Medicare home health payments by $13.16 billion over the next five years. If the President’s proposal is allowed to pass, Massachusetts would lose $16.7 million in Medicare reimbursement for fiscal year 2010 alone. The Government Accountability Office (GAO) report may have uncovered sporadic fraud in home health, but a better approach to controlling Medicare home health spending is to prosecute and punish the few agencies responsible for that fraud instead of reducing rates.

Again, please contact the offices of Congressman McGovern and/or Congressman Jones to support your constituents who deliver and receive home health care services.

Sincerely,

Patricia Kelleher
Executive Director

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2009 Compensation and Benefit Surveys Available


We’re pleased to announce that the 2009 Compensation & Benefits Survey Reports are now available for purchase on our publications store.

The 2009 Compensation & Benefits Survey Reports provide salary and professional rate ranges for all positions in the home care industry. They are indispensable tools for HR managers, proving a quick and accurate reference of industry pay standards for your employees.

The Alliance publishes two surveys: one for Medicare/Medicaid certified agencies, another for private duty agencies.  Both display state-wide results, as well as data based on geographic area and agency size.

The 2009 surveys contain information about prevailing pay and benefits for the full range of positions in home care agencies.  Both surveys list pay and benefits figures for dozens of positions, including: executive, administrative, supervisory, care giving, and clerical positions.  In addition to listing state-wide results, the surveys also publish figures organized by geographic region and company net revenue.

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Think Home Care, July Issue

The July Issue of Think Home Care is now available for download.  The full text is also available below.

Return to www.thinkhomecare.org.

Continue reading “Think Home Care, July Issue”

Letter to MA Congressman: Stop Cuts to Home Care

Three committees in the US House of Representatives – House Ways & Means, House Energy and Commerce, and House Committee on Energy and Labor, each with their own subcommittee on health – have jointly submitted a health care reform proposal known as the Tri-Committee Health Reform Bill.

The legislation includes the Medicare Payment Advisory Commission’s (MedPAC) recommendations that Congress eliminate the home health market basket update for 2010 and accelerate the application of the 2011 coding creep adjustment proposed for 2011 (2.71 percent) to 2010 – reducing current rates in 2010 by 5.46 percent. MedPAC also recommended that Congress direct CMS to rebase home health payments in 2011, using 2007 costs as a base.

this effort would bring devastating cuts, which over ten years would take $51 billion from the Medicare home health program, according to the Congressional Budget Office (CBO).

Recently, the Alliance’s Executive Director Pat Kelleher and Board President Patricia O’Brien sent a letter (see below) to Massachusetts Congressmen highlighting our major concern over this proposal. Please help us advocate by clicking here and sending an email message to YOUR Congressional representative (see first message under “Federal or National Issues”).

Dear Congressman:

On behalf of the 150 home care agencies that comprise the Home Care Alliance of Massachusetts,  I write to express our strong concerns with provisions in the U.S. House of Representatives’ “Tri-Committee Health Reform Proposal,” which calls for catastrophic cuts to the Medicare home health program.

It is estimated that the House proposal would cut home health Medicare payments by $51 billion over ten years.  The proposal would eliminate the home health market basket update for 2010 and accelerate the application of the payment adjustment proposed for 2011 (2.71 percent) to 2010—reducing current rates in 2010 by 5.46 percent.   For Massachusetts, this means that Medicare home health reimbursement would be reduced by more than $16 million in the next year alone and more than $300 million over the next five years.

Cuts of this magnitude would deal a devastating blow to Massachusetts home health care.  Massachusetts home health agencies have seen almost no or miniscule increases in our Medicare payments over the last seven years.  Many home health agencies are already in financial jeopardy as a result of Medicaid cuts and inadequate Medicare Advantage payments.

Using cost report data from 2008, we have estimated that should these reductions be sustained, half of the home health agencies in Massachusetts, including virtually all of our safety net VNA’s, would have negative operating margins in FY 2010.

The recommendations for home health cuts come from MEDPAC studies that do not reflect what is happening in your district. These studies use a weighted average, combining all home health agencies into a single unit, rather than recognizing the individual existence and local nature of each provider. MEDPAC’s recommendations also fail to evaluate the impact of the completely reformed – and reduced – home health payment model put in place in 2008.

The Home Care Alliance supports health care reform and coverage expansion that is based on sound health care policy principles and builds on the strengths of our current system.  In supporting our call for reversing this cut, we call your attention to a study by Avalere Health (May 11, 2009: see attached) that found home health use saves Medicare dollars by reducing hospitalizations and nursing home stays.  Based on the findings in this study, an estimated $30 billion could be saved over the next ten years by expanding access to home health for chronic disease patients.

An underfunded home health system would hurt the most vulnerable elders in your district and will cause a ripple effect in the rest of the system backing people up in hospitals and costing Medicare and the taxpayers more money (After the Balanced Budget Act of 1997 cut billions from the Medicare home health benefit, Medicare expenditures on skilled nursing facilities and hospitals skyrocketed).

The Home Care Alliance is aware of the pressure on the current Medicare program to find efficiencies that can support expanded insurance access.   Our member agencies have supported efforts – endorsed by the National Association for Home Care – that would

·         Enact a moratorium on new certifications of Medicare participating home health agencies. Most of the questionable growth in home health expenditures has occurred in states with a saturation of home health agencies. For example, Texas has had a 200% increase in spending following a 100% increase in HHAs. In Houston alone, there are more HHAS than in New York, New Jersey, Pennsylvania, and Maryland combined

·         Institute a revenue-based provider-specific cap on outlier payments prohibiting outlier payment on a set percentage of an HHA’s Medicare home health revenue in a calendar year.   There is strong evidence that a minority of home health agencies are abusing the outlier payment system. While small in numbers, these providers have taken well in excess of $1B in outlier payments from the total of $16B in annual home health expenditures

The potential savings through this proposal are $4-8B over 5 years/ $16-23B over 10 years.

We appreciate your support for our agencies and the frail elders that are the beneficiaries of our services.

Return to www.thinkhomecare.org.

Providence (RI) Business News: Advantages, Barriers to Physician Use of Home Health Services

The recently released survey conducted by the Massachusetts Medical Society, in collaboration with the Home Care Alliance, was covered in a July 6 story by the Providence Business News.

Click here to see the story and check out the Alliance News Feed to see the results of the MMS survey.

Some of the higlights include:

Advantages: The main advantages to home services cited by physicians were better compliance with the patient’s care plan (78% of respondents), reduced stress on caregivers (73%), improved coordination of care (65%), and fewer visits to emergency departments (63%). An overwhelming number of physicians – 97% – say the services help them better manage their patients’ care at home.

Barriers: The main barriers to using these services cited by physicians were administrative burdens (paperwork, 54%), reimbursement issues (40%), and availability of workers (33%). The barrier of reimbursements, however, appears to be one that can be readily fixed by education and information: of the 71% of physicians who reported that they did not submit charges to Medicare for the services, 64% of those said they were unaware of the reimbursement.

Reduced Stress on Caregivers: The benefit of reducing caregiver stress by using these services was cited by 73% of physicians – an important consideration as more and more family members are pressed into caring for their elders for longer periods of time. According to the National Alliance for Caregiving, an estimated 44 million Americans age 18 and older – about 21% of the population – provide unpaid care to another family member. And recent surveys and published reports have indicated the economic recession has put further strain on caregivers: as services are cut, caregivers are carrying much more of the financial load for care and in many cases are dividing time between working and caregiving.

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Survey Results: Physician Perceptions, Use of Home Health Services

A Massachusetts Medical Society survey, performed in collaboration with the Home Care Alliance, has shown that a vast majority of physicians believe home health care services provide multiple advantages in improving health care quality and reducing costs without compromising outcomes, but administrative burdens, reimbursement issues, and lack of access to the services are regarded as main barriers to using these services.

Click here to see the full results of the physician survey.

Advantages: The main advantages to home services cited by physicians were better compliance with the patient’s care plan (78% of respondents), reduced stress on caregivers (73%), improved coordination of care (65%), and fewer visits to emergency departments (63%). An overwhelming number of physicians – 97% – say the services help them better manage their patients’ care at home.

Barriers: The main barriers to using these services cited by physicians were administrative burdens (paperwork, 54%), reimbursement issues (40%), and availability of workers (33%). The barrier of reimbursements, however, appears to be one that can be readily fixed by education and information: of the 71% of physicians who reported that they did not submit charges to Medicare for the services, 64% of those said they were unaware of the reimbursement.

The survey also touched on the potential to reduce caregiver stress and also the disparity in home health usage by primary care doctors versus specialists.

Return to www.thinkhomecare.org.

Brockton Enterprise, Patriot Ledger: Home Care Champion

The Brockton Enterprise and Patriot Ledger of Quincy recognized Robert Dwyer who is the board treasurer for Norwell VNA and Hospice in their “mover & shakers” section.

Dwyer was given the “Home Care Champion” Award at the Alliance’s 2009 Spring Conference.

To see the announcement, click here.

Now in his 15th year on the board of the Norwell VNA, Mr. Dwyer had previously worked as a corporate counsel in the banking industry. When Medicare payment system changes were implemented, Mr. Dwyer personally advocated on the state and federal levels in opposition to inefficient business practices. Mr. Dwyer has also helped to guide Norwell VNA and Hospice through a merger and an expansion from a two-town agency to one that serves more than 20 communities on the South Shore.

Norwell VNA and Hospice Executive Director Meg Doherty added, “Through all of our changes, Bob has been a constant for NVNA and Hospice; ever present with his strong and supportive counsel, wise leadership and strong business ethics. He is a gentleman in every sense of the word and the epitome of a non-profit board member.”

Return to www.thinkhomecare.org.