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This Bill Would Undo Medicare Home Health Cuts Under Obamacare

Published by The Daily Signal
Melissa Quinn
July 16, 2014

House Republicans propose to roll back major cuts in Medicare home health services, saying they want to help senior citizens and other Americans who face decreases in both care and jobs.

A bill introduced yesterday by Reps. Greg Walden, R-Ore., and Tom Price, R-Ga., would repeal the Obamacare-inspired cuts of 14 percent imposed by then-Health and Human Services Secretary Kathleen Sebelius.

In place of the cuts, set to take place over four years, Walden’s bill would reward home health agencies for providing high-value care to patients.

In a statement announcing the bill, called the Securing Access Via Excellence for (SAVE) Medicare Home Health Act, Walden said:

We’ll get more for our money and better care for patients without these cuts across the board. This common-sense bill will stop the administration’s cuts to home health care, and allow … seniors to continue to receive the care they need and that depend on.

Republican co-sponsors include: Cathy McMorris Rodgers of Washington, Renee Ellmers of North Carolina, David McKinley of West Virginia, Tom Latham of Iowa, Sean Duffy of Wisconsin, Glenn Thompson of Pennsylvania, Sam Graves of Missouri, Charles Boustany of Louisiana, and Erik Paulsen of Minnesota.

Walden spokesman Andrew Malcolm told The Daily Signal that although is not yet a companion bill in the Senate, the idea is gaining interest.

More than 3.5 million elderly Americans receive services through home health care, with funding provided by Medicare. To be eligible, an individual must be homebound, require skilled nursing care or rehabilitation services, and be under the care of a doctor who established home visits as medically necessary.

Analysis conducted by Avalere Health found that the majority of beneficiaries are older, sicker, and poorer than the typical Medicare recipient, with many living in rural areas without immediate access to hospitals or other care facilities.

The Affordable Care Act, popularly known as Obamacare, authorized the Department of Health and Human Services to cut or increase categories of Medicare spending. Republicans and Democrats alike were surprised to learn, however, that Sebelius imposed the maximum cuts allowed under Obamacare, slashing home health care funding by 3.5 percent annually until 2017.

The cuts, finalized in November and in effect since January, left more than 1 million seniors without access to home health care services.

According to the administration’s own analysis, roughly 40 percent of the nation’s more than 11,000 home health care agencies could lose money by 2017.

The industry already was suffering, reports indicate. The February jobs report from the Bureau of Labor Statistics found the home health care sector lost 3,800 jobs that month — a month after the cuts went into effect.

Industry leaders attributed the job losses to the HHS’s cuts. They also represent the single highest monthly loss posted in the home health care sector in more than 10 years. Roughly 3,700 jobs were lost in December, a month after HHS finalized spending for home health care through Medicare.

In a statement, Price criticized the Obama administration for implementing cuts that hurt elderly Americans and cost other Americans their employment. He said:

That’s a direct threat to the quality and accessibility of health care for Medicare beneficiaries. More importantly, it is completely unnecessary. We can achieve the same level of savings by making home health care under Medicare more efficient with a focus on promoting and rewarding higher quality care. It’s a patient-centered approach that puts the well-being of beneficiaries and care givers first and foremost.

The more than $50 billion in cuts to Medicare home health care estimated by the Congressional Budget Office and the home health community initially were imposed as a way to pay for the Affordable Care Act. Walden and Price say their reforms would achieve the same savings through “value-based purchasing.”

The policy, included in bill on nursing facilities passed in February with bipartisan support, is based on a pay-for-performance system. Home health care agencies would be rewarded monetarily for meeting or exceeding goals set by the Centers for Medicare and Medicaid Services, a division of HHS, for keeping patients out of hospitals. Those that fail to meet the goals would face a penalty.

Eric Berger, chief executive officer of the Partnership for Quality Home Healthcare, praised the system proposed by Walden-Price bill. In an interview with The Daily Signal, Berger said:

The bill utilizes a proven, positive reform as an alternative source of savings in place of the rebasing cut, which is a negative, unpopular source of savings.

Berger also noted that HHS’ cuts in home health care disproportionately affect women.

An analysis by Avalere Health found that more than 5 million women are affected directly, since women make up the majority of home health care beneficiaries, caregivers, and professionals in the industry.

“We believe that the true impact of this cut was not fully and properly analyzed when it was enacted,” Berger said.

Although the Walden-Price bill has yet to garner Democratic support, Berger said it is something both parties can rally behind. When HHS originally proposed the cuts to Medicare home health care funding, more than half of all members of Congress asked the agency not to do so, he said. Senate Democrats also joined Republicans in calling on HHS to reduce the size of the cuts.

The Walden-Price bill also wouldn’t increase the deficit, Berger said, a feature that is attractive to lawmakers across the political spectrum.

“It’s good for seniors, it’s good for their families, and it’s good for taxpayers,” he said.

See the original article here.

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