Home Health & Hospice Week

A home health agency copayment wouldn't just be bad for providers, it could also be devastating for patients and government spending, industry advocates warn.

Copays "are wrong-headed ideas that have not only been proven to have a number of detrimental effects on beneficiaries requiring services, but to actually drive up health care costs," stresses the National Association for Home Care & Hospice. "Requiring the sickest of Americans to pay a fee to access home health care is an old and discredited idea," says NAHC's Val Halamandaris.

"A co-payment would create a significant access barrier for Medicare beneficiaries who need medically necessary home health care per their doctor's orders," Andy Carter of the Visiting Nurse Associations of America says in a release. "These patients are much more likely to end up back in the hospital or another institutional setting at much greater costs," Carter says.

HHAs report that they are seeing fallout just from the recommendation for the copay. "We are already getting calls from patients who want to be discharged so they don't have to pay a copay, and it is just a proposal!" says Sharon Snider, director of Nason Hospital Home Health Agency in Roaring Spring, Pa. Patients' fears have been sparked by newspaper reports implying that the copay recommended by the Medicare Payment Advisory Commission is a done deal.

Up next: NAHC, VNAA, and other industry members and representatives will come out swinging against the copay in this legislative session. "The home care community is made up of seasoned veterans of 'copay wars' who are ready and able to stop this bad idea at its doorstep," NAHC notes in its member newsletter.

The industry won a similar battle against copays in 2003, the trade group notes.

HHAs should have some heavy hitters on its side. The influential AARP is opposing the copays, according to press reports.

Watch for: An indicator of how hard the copay battle will be to win may be President Obama's forthcoming budget proposal for 2012. If the budget proposal contains any of MedPAC's recommendations, they will be harder to overcome, NAHC predicts.