HCA Issues Statement on Home Care Copay Proposed by President

In response to President Barack Obama’s proposal to impose a co-payment on Medicare home health services, the Home Care Alliance has issued a release to the press. Any home care agencies or concerned advocates is encouraged to follow up with local media and make the public aware of this proposal.

Below is the Home Care Alliance’s statement:

President Proposes Home Health Copays to Help Reduce Federal Deficit

Industry Calls Copayments an Inappropriate Burden and a Tax on Most Vulnerable Elders

Boston, MAWith the debate over the federal budget debt ceiling heating up, the Home Care Alliance of Massachusetts has joined organizations from across the nation in vehement opposition to President Barack Obama’s proposal to impose co-payments for Medicare Home Health Services.

What began as a recommendation to Congress by the Medicare Payment Advisory Committee (MEDPAC) is now entrenched in discussions over how the country will raise revenues and reduce spending.

“It has been shown in many studies that copayments are an inefficient and regressive ‘sick tax’ that falls most heavily on the poorest and oldest Medicare beneficiaries,” said Patricia M. Kelleher, the Executive Director of the Home Care Alliance of Massachusetts. 

Congress eliminated home health copayments in 1972 as part of a Medicare modernization effort that concluded that such copayments fell disproportionately on the home health users with the highest Medicare expenses and the worst health status. Moreover, they discouraged using home health in lieu of more expensive nursing facility stays. As recently as 2003, Congress rejected a home care co-pay proposal for the same reasons.

President Obama’s proposal calls for a copayment of $100 per Medicare episode and excludes Medicare episodes immediately following a hospital stay. The measure would only apply to new beneficiaries beginning in 2017 and is estimated to save approximately $400 million over 10 years.

“Imposing of a copayment would continue an assault on the Medicare home health benefit that witnessed $39.7 billion in cuts passed by Congress last year,” said Kelleher. “Additionally, on January 1, 2011, Medicare added a new impediment to accessing services by requiring that homebound elderly and disabled patients, as well as hospice patients, will now need to have a ‘face-to-face encounter’ with a physician or nurse practitioner in order to receive home health services under Medicare.”

Most home health users are age 75 or older and in very poor health.  A Commonwealth Fund Report recently found that individuals of all incomes with fair or poor health status or age 85 and older spent almost 30 percent of their income already on uncovered medical care, primarily due to Medicare gaps, deductibles and copayments. Additional publications, including the New England Journal of Medicine, have released findings that an increase in such copayments lowers utilization and increases hospitalizations.

“Home health agencies in Massachusetts have supported aggressive efforts to slow growth of home health spending, including testifying in support of a moratorium on new agencies,” said Kelleher. “Asking patients to pay more is not the answer.”   

Return to www.thinkhomecare.org.

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