Home Health & Hospice Week

Home health agencies have been garnering negative attention from the Medicare Payment Advisory Commission and others about their high average profit margins. MedPAC figures the margin at 11 percent this year.

And now national attention has focused on high HHA executive salaries, thanks to a profile in the April 12 Parade Magazine's "What People Earn" issue. Jimmy Jamie, the 26-year-old CEO of HHA chain Golden Heart inWest Virginia, Ohio, and Texas, was listed as earning an annual salary of $2.2 million -- just $50,000 less than Britney Spears.

Golden Heart is owned by Jamie's mother, notes an article in the Charleston Gazette. His father and sister are physicians; he dropped out of Harvard medical school after a year. The former tennis pro still gives tennis lessons on the side, the newspaper adds.

This kind of attention from the mainstream press is bad publicity for the industry, just when it's trying to head off major cuts in Congress, worries consultant Tom Boyd with Rohnert Park, Calif.-based Boyd & Nicholas.

One of the best parts of PPS is not having to go through the painful cost report auditing process, notes William Dombi with the National Association for Home Care & Hospice. HHAs can put their money where it's most needed without worrying about cost report vetoes.

But the downside is that there are no controls on HHA exec salaries under PPS. "There's no agency in the world where that [salary] is allowable," Dombi says of the report.

This kind of anecdote may add fuel to MedPAC's fire to restructure HHA payments under Medicare. The influential advisory body to Congress has already suggested implementing payment caps for HHAs and going back partially to costing, Dombi notes.

NAHC is against a return to cost-based reimbursement and instead supports "better alternatives," Dombi tells Eli. Cost-based reimbursement is "a huge administrative cost" for HHAs.