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Medicare patients deserve better

Published by Sun Herald
Karin Barnard
May 24, 2016

Medicare's home health-care benefit is widely regarded as a clinically appropriate and cost-effective health-care setting preferred by American seniors.

As seniors manage chronic conditions and myriad health challenges that arise as they age, Medicare's home health-care benefit offers them access to care that keeps patients at home -- and out of the hospital.

Despite the clinical and fiscal benefits of home care, Medicare would like to require prior authorization of home-health services, which means after a patient's physician prescribes home care, a government bureaucrat will have to review the order and decide if the care is warranted and approved. All the while a sick and weak senior is at home, with no medical supervision, waiting for Medicare's approval.

Considering many patients are prescribed home health care when leaving the hospital, a prior authorization requirement is even more troubling. Physicians prescribe home care to ensure patients heal properly and safely under supervision so as not to experience repeat hospitalizations. Medicare's idea to create lengthy delays for home care directly contradicts its commitment to reducing hospital costs through patient-centered care.

Though Medicare hopes this policy would reduce fraud and abuse in the home health sector, there is no evidence prior authorization would deter dishonest people from taking advantage of the system. Instead, targeted solutions are needed that promote program integrity while protecting patient access to timely, safe and clinically effective home health.

I urge our state lawmakers to join me in opposing Medicare's prior authorization to home health care. Our state's Medicare patients deserve better than policies that restrict access to care.

Read more on the Sun Herald website.

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