Home Health & Hospice Week

Congress may not be poised to hit the August recess deadline for health care reform legislation that President Obama wanted, but reform talks continue to forge ahead despite the slow-down, with mixed results for home care.

In the Senate, bipartisan Senate Finance Committee talks continue, although Republican Sen. Orrin Hatch (Utah) departed the negotiations. Senate Finance leaders have expressed optimism that a bill will be introduced and the committee will begin considering it before the recess begins Aug. 7.

A full Senate vote is expected after the recess. In the House, the Energy and Commerce Committee continues to be the last committee of jurisdiction still considering the health care reform bill. Prospects for passing the bill before August recess begins Aug. 3 were looking dim at press time. In the House too, a full vote is expected after recess. Once both houses of Congress vote on their respective reform packages, there's even tougher work ahead, observers note. Aconference committee will be tasked with working out the (likely significant) differences between the two bills.

Concern: A common component expected to make it into both bills is drawing lots of provider fire -- the establishment of the Independent Medicare Advisory Council (IMAC), a MedPAC-like body that would have independent rate-setting authority over Medicare.

Influential provider groups such as the American Hospital Association have come out against the provision, according to press reports.

And while big physician trade groups are staying mum on the concept, individual doctors are speaking out against it, says the Wall Street Journal.

The National Association for Home Care & Hospice "believes the proposal would give IMAC too much power and have Congress yield its power to the Executive branch," the trade group says.

"Further, IMAC would not have broad based experience given that it would be comprised of only five members appointed by the president."

Another problem: "Unpredictability would reign from year to year as the IMAC could change rules with little input from Congress or the public," NAHC predicts.

House Ways and Means Select Revenue Measures Subcommittee Chair Richard Neal (DMass.) is circulating a "Dear Colleague" letter asking House Speaker Nancy Pelosi (D-Calif.) to reject the IMAC and similar proposals in the final version of the House bill, NAHC notes.

Meanwhile: Home care providers are taking heart from comments President Obama made in a July 23 town hall meeting about health care reform in Shaker Heights, Ohio.

"In some cases, we may need higher reimbursement rates for certain aspects," the President said in response to a question from a home care provider in the audience. "I actually think home care ends up being cost-efficient in many cases rather than institutional care -- and it helps keep people in their homes."

"We applaud the President's recognition of home care as a cost-effective alternative that reduces healthcare costs and allows millions of seniors to live in the comfort of their own homes," says the American Association for Homecare's Tyler Wilson. "We urge Congress to recognize that home care should be a critical component -- not a casualty -- of health care reform."

End-Of-Life Provision Catches Flak An end-of-life provision contained in House reform legislation has become a hot spot in the ongoing debate. The provision calls for Medicare