Walden introduces home health care bill

Rep. Greg Walden unveiled legislation Tuesday designed to lessen the impact of cuts to Medicare payments made to home health care providers by the Obama administration.

Medicare reimburses health care companies for providing in-home care in part to reduce the costs incurred by longer stays in hospitals and nursing homes. Over the past decade, the home health care industry has grown dramatically. The Centers for Medicare and Medicaid Services decided the government’s payments were overly generous and cut them by 3.5 percent each year from 2014 to 2017, the maximum reduction allowed by the Affordable Care Act.

Under these industrywide cuts, 40 percent of home health care companies would be losing money by 2017, Walden said during a conference call with reporters. In Oregon, that figure approaches 70 percent, according to the Medicare Payment Advisory Commission.

The Partnership for Quality Home Healthcare concluded that more than 15,000 Oregonians could lose access to their in-home providers and almost 3,000 home health care professionals in Oregon could lose their jobs, Walden said.

“Home health care allows patients more control over their health care, and provides a sense of comfort, familiarity and normalcy for the patient and their family,” Walden said.

Walden’s legislation would set aside the reimbursement cuts from 2015 to 2017 and would instead reward top-performing firms with incentive bonuses. The goal is to replace the across-the-board cuts with payments that target firms providing demonstrably better results.

In December, Walden and 141 other representatives, including Rep. Earl Blumenauer, D-Portland, wrote to Centers for Medicare and Medicaid Services administrator Marilyn Tavenner, urging her to reconsider the announced reimbursement cuts.

Projections put the reimbursements below company costs in every state by 2017, the letter stated.

“As a result, we are concerned that the proposed rule would have a direct impact on access for millions of seniors, many of whom reside in rural and underserved communities,” the letter reads.

“A significant amount of this care in rural and underserved areas is provided by thousands of small businesses that would be most at risk of going out of business under the proposed rule.”

Walden introduced the legislation, which requires the Department of Health and Human Services to study the effect of home health care payments for patients and the industry, particularly in rural communities. Rep. Tom Price, R-Ga., who was an orthopedic surgeon before turning to a career in politics, also sponsored the bill, which was immediately co-sponsored by nine additional House members, all Republicans.

Walden spokesman Andrew Malcolm said the bill’s sponsors would welcome support from Democrats, but none has signed on to date.

“This shouldn’t be a partisan issue,” Malcolm said.

In May 2013, there were 3,940 home health care workers assisting people who are disabled, chronically ill or cognitively impaired in Oregon, according to the Bureau of Justice Statistics. Between 2012 and 2022, the bureau projected the industry would add another 424,200 jobs, an increase of 48 percent.

Critics of the administration’s reimbursement cuts maintain the government is overestimating the operating margins for home health care companies. While the Medicare Payment Advisory Commission put their margins at 13.7 percent, a study of publicly traded home health companies based on Securities Exchange Commission filings by the health care policy and analysis firm Avalere concluded operating margins were 2.8 percent.

Walden’s announcement met with approval from national and local industry organizations.

“Oregon has long been a leading provider of high-quality, cost-effective care through innovative health care, including home care to Oregonians in need. Congressman Walden’s support and sponsorship of the SAVE Medicare Home Health Act is further demonstration of his understanding of the importance of home health care in our state,” said Shaune Mattsson, president of the Oregon Association for Home Care.

“Incentivizing home health care agencies to deliver high-quality care to beneficiaries and reduce hospital readmission rates represents a positive and proven approach to achieving savings without disrupting patient care,” added Eric Berger, CEO of the Partnership for Quality Home Healthcare. “With 3.5 million seniors currently depending on skilled home health care, policy solutions such as this are vital to preserving and improving these essential services.”

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