Health Care Reform – Implications for Home Health Care

“The Congress completed a historic process yesterday — the new legislation will transform American health care and place home and community-based care at the center of the action,” said Val J. Halamandaris, president of the National Association for Home Care & Hospice (NAHC).

Impact on Home Health and Hospice
The White House and Congress agreed to a combination of tax increases and spending reductions to help finance the expansion of health insurance coverage to tens of millions of additional Americans. Roughly half of the financing comes from changes to the Medicare program. NAHC worked intensely with key members and staff in the U.S. Senate in successfully modifying provisions in the House bill to ensure that the changes to home health and hospice were more targeted, less onerous, and spread over a longer period of time so that agencies could adapt their operations and care practices to the changes.

As a result, rather than reducing scheduled home health outlays by $57 billion over the next 10 years, this final legislation reduces projected growth by approximately $39 billion over the same period. In total, projected outlays for home health were expected to total $318 billion, while under the new legislation overall 10-year spending is estimated to be roughly $279 billion.

The year-by-year impact on Medicare hospice payments is less clear. Even so, the approved bill delays imposition of an annual productivity adjustment to the hospice market basket until the beginning of fiscal year 2013. The final legislation also takes major steps toward modernizing the hospice program by laying the groundwork for a revamp of the Medicare hospice payment system and through a Medicare demonstration that will allow hospice beneficiaries to receive, concurrently, regular Medicare services. In addition, the legislation allows Medicaid-eligible children to receive hospice care without forgoing other health care services under the program.

Going Forward
The health care reform bill is a combination of new opportunities for home care — and threats to the viability of the home health services community that could surface with the Medicare rate changes in the bill. NAHC intends to maximize the value and impact of the reform’s improvements in home and community-based care while continuing efforts to modify or mitigate the changes to the Medicare rates.

NAHC has developed updated comparison charts of the home health-specific provisions of the legislation that are available on the NAHC website – www.nahc.org.

Stay tuned…and stay informed!