Home Health & Hospice Week

Congress has yet to pass the final word on home care cuts this year, but the outlook is grim.

On Christmas Eve, the Senate approved massive health care reform legislation which includes cuts to home health agency and hospice reimbursement levels under Medicare. The Senate legislation would cut HHArates by $39 billion over 10 years, notes the National Association for Home Care & Hospice. That's nearly $3 billion less than first proposed, thanks to some last-minute amendments from home care-friendly Senators.

That's compared to more than $55 billion in home care cuts in the health care reform bill the House passed back in November (see Eli's HCW, Vol. XVIII, No. 40, p. 308).

"The Senate's legislation takes a far better approach," NAHC judges. "Cuts to home health providers ... are considerably more moderate, phased-in over time, and targeted in part toward abuses in the system."

On the other hand, the more draconian House bill favors "across-the-board cuts that would harm the vast majority of 'good players' among home health providers while potentially leaving abusers as the last standing," the trade group concludes.

Negotiators from the House and Senate will now have to work out a compromise bill that both chambers can pass to send to President Obama. Observers expect that may take a few months, considering the contentious differences in the non-home care sections of the health reform package.

The cuts are going to leave many agencies, including non-profit visiting nurse associations, with hard choices, notes the VNAs of America. The cuts will endanger programs for the needy, VNAs worry.