Home Health & Hospice Week

Grappling with current regulatory and reimbursement requirements is tough, but keep an eye out for even more severe legislative developments for the future.

Members of Congress and the Obama administration are knee-deep in budget talks, with a focus on trying to find budget savings. And a prime target is Medicare spending.

Proposals ranging from increasing the Medicare eligibility age to upping Medicare premiums are on the table. And a proposal for a home health agency copayment continues to be discussed among lawmakers, with a serious chance of making it into legislation this year, industry experts predict. But HHAs have some concrete study findings to fight that move.

About 55 percent of 2008 home health users would have been subject to the full $150 copayment amount suggested by the Medicare Payment Advisory Commission, found a recent study conducted by Avalere Health. Such a per-episode copay would constitute a significant financial burden and would affect a vulnerable population, the study says. Such a copay would consume 3 percent of the income of a bene living at 150 percent of the Federal Poverty Line, Avalere points out. And 58 percent of the benes subject to the copay live below 200 percent of the FPL.

Lawmakers can expect a copay to have unintended consequences such as increased inpatient costs and adverse health events, the study warns.

Meanwhile, Avalere also released a new study outlining some benefits of home care. Home care after initial hospital episodes prevented more than 20,400 hospital redmissions from 2006 to 2009 in the Medicare program, the study says. That saved $2.81 billion in Medicare hospital spending during the time period. The study was commissioned by the Partnership for Quality Home Healthcare, an industry advocacy group.