Home Health & Hospice Week

MedPAC may soon be calling the Medicare reimbursement shots.

Change is in the air, but so far it's unclear whether health care reform will be good or bad for home health agencies and hospices.

Right now, home care providers are doing everything they can to make sure the changes under consideration by Congress and President Obama are positive for the industry, their workers, and their patients.

Lawmakers and big industry lobbyists are currently embroiled in battles over numerous health care reform points, including whether the reform plan will have a requirement for mandatory insurance and whether the government will offer a public insurance option. But many home care providers are more concerned about how they'll be treated by Medicare under the new system.

Case in point: President Obama recently called for an additional $200 billion in Medicare cuts to help fund overall health care reform. That's in addition to the HHA cuts the administration proposed in its 2010 budget.

In its search for budget cuts, Obama has endorsed Sen. Jay Rockefeller's (D-W. Va.) bill to give the Medicare Payment Advisory Commission rate-setting authority for Medicare providers, according to press reports. Rep. Jim Cooper (DTenn.) has introduced a House companion bill.

Giving MedPAC such power would be bad news for home care, since the commission has recommended cuts to HHA rates many years in a row.

"The National Association for Home Care & Hospice opposes the move based on long-standing concerns relative to limitations in the panel's research and analysis, and its resistance to input from outside sources during deliberations," it says.

Namely, MedPAC has been very focused on overall HHA profit margin without taking into consideration the large proportion of agencies with very low margins, the trade group says.

Meanwhile, lawmakers continue to push their agendas in the health care reform debate. Sen. Mark Warner (D-Va.) has introduced a bill addressing many end-of-life and chronic care issues, including adding more counseling and care management services for such patients to improve quality of life while reducing spending on unnecessary tests and interventions.

And 18 senators and 54 representatives have signed on to the Dear Colleague letter opposing home health cuts, NAHC reports. Thirty-three senators signed onto a letter urging restoration of the cuts to hospices due to the budget neutrality adjustment factor (BNAF) phase-out.