September 26, 2011

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ROSWELL, GA — Amidst Congress’ ongoing task to trim $1.2 trillion from the federal deficit, Congressman Tom Price, M.D. (R-GA) joined home healthcare providers, clinicians and family members today to discuss the value of home care services in the state, as well as current challenges — including the possibility of significant cuts to Medicare payments for skilled home healthcare and co-payments for seniors.

“Home healthcare throughout the state of Georgia, and nationwide, has proven itself to be a valuable service for the more than 3.5 million Americans who depend on it each year,” said Congressman Price. “The highest priority is to maintain high-quality skilled care for those in need, and the provider community should be commended for their efforts to do so in a way that is cost-effective so as to save tax dollars for all Americans.”

Georgia’s home healthcare community welcomed today’s event as an opportunity to share how home healthcare providers are efficiently and cost-effectively managing many chronic diseases — including Chronic Obstructive Pulmonary Disease (COPD), diabetes, and heart disease — which might otherwise require a patient to seek care in a costlier hospital or other in-patient setting. Providers and clinicians are urging decision makers to recognize home healthcare’s significant ability to reduce costs within the Medicare program. More than 100 Medicare-certified home health agencies in Georgia provide specialized in-home care, and clinicians made more than 2 million visits in 2010, according to data from the National Association for Home Care & Hospice (NAHC).

A June 2011 study by Avalere Health, LLC showed that home health use was associated with a $2.81 billion reduction in post-hospitalization Medicare Part A spending between 2006 and 2009. Specifically, Medicare Part A spending on home health users in this four year span was $2.81 billion less than it would have been if they had received post-acute care services in other settings — such as care in a skilled nursing facility, long-term acute care hospital or inpatient rehabilitation facility.

In addition to the inherent savings provided through skilled home healthcare, providers in Georgia and nationwide have developed initiatives to achieve meaningful savings by eliminating improper Medicaid and Medicare payments, and putting a stop to waste, fraud and abuse. Estimates show that improper payments and fraudulent activity cost U.S. taxpayers at least $70 billion annually.

“It’s the collective responsibility of the entire home healthcare community, and all Americans, to safeguard the important care on which millions of Americans rely,” said Val J. Halamandaris, president of the National Association for Home Care & Hospice (NAHC). “For providers, this includes proactively offering solutions to current economic challenges, which is why we are so pleased to have this opportunity to share our ideas and initiatives with Congressman Price.”

Members of the home healthcare community are calling on Congress to avoid implementing co-payments for seniors, especially in light of a new analysis that shows co-payments for home healthcare services will potentially increase Medicare spending for inpatient hospital and post-acute care (PAC) treatment by up to $16.7 billion over ten years. Further, research shows that co-payments could drive up Medicaid costs by as much as $2.4 billion over ten years.

The community is also urging lawmakers to avoid across-the-board cuts, which would further destabilize an already shaky situation. A September analysis by NAHC and the Moran Company revealed that changes proposed by the Centers for Medicare and Medicaid Services (CMS) to the home health prospective payment system would force many providers of Medicare home healthcare services to operate in the red. Specifically, the analysis found that 65.7 percent of rural providers and nearly 81 percent of hospital-based agencies nationwide will see negative Medicare margins if the CMS-proposed rate adjustments are finalized. In Georgia, 75 percent of hospital-based providers and almost 53 percent of rural providers would experience negative Medicare margins.

Home health care has become increasingly important to millions of American seniors who depend upon it for skilled post-acute care. Approximately 3.5 million Medicare beneficiaries annually receive home health care to recuperate from serious injury or illness at home — at a significant cost savings when compared to other care settings. In Georgia, skilled home healthcare keeps more than 80,000 Georgians at home and out of costlier care settings