Gov. O'Malley warns beneficiary cost sharing for Medicare home health patients will threaten access for vulnerable, frail seniors
WASHINGTON, Dec. 6, 2013 /PRNewswire-USNewswire/ -- The Partnership for Quality Home Healthcare – a coalition of home health providers dedicated to improving the program integrity, quality, and efficiency of home healthcare for our nation's seniors – today commended Maryland Governor Martin O'Malley for expressing concern to leaders in the U.S. Senate and House of Representatives about the unintended, overlooked and deeply negative consequences of re-imposing cost sharing for skilled home healthcare services needed by 3.5 million Medicare beneficiaries.
Lawmakers have proposed re-imposing copays on Medicare home health beneficiaries, which would have negative consequences for a Medicare population that is statistically proven to be older, sicker, poorer and more likely from a minority population when compared to the Medicare population as a whole. Analyses show that the re-imposition of a copay would cause a substantial financial burden for these patients.
In a letter to both U.S. House and Senate leadership, Governor O'Malley asks that Congress revisit and carefully analyze the consequences of copays on already struggling seniors. He noted that Congress already repealed a home health copay in 1972 "…because it placed a heavy financial burden on low-income beneficiaries and forced many of them into higher-cost institutional settings."
Furthermore, Governor O'Malley recognizes the strong link between the home healthcare community and its ability to fuel job growth stating, "Indeed, the Bureau of Labor Statistics (BLS) data consistently demonstrate that the home health sector is a primary engine of new healthcare jobs, at a time when much of the labor market is struggling, due in no small part to seniors' strong preference to receive treatment in the comfort, safety and dignity of their homes."
The Governor also expresses concerns for the financial consequences a home health copay would have on state Medicaid programs. Because it would impose a substantial financial burden on low-income Medicare beneficiaries, a home health copay would be a new unfunded mandate on States, which would have to cover the cost of the copay for dual-eligibles and Qualified Medicare Beneficiaries (QMBs). Further, Avalere Health estimates that the re-imposition of a home health copay could lead to $16.7 billion in additional Medicare spending due to increased facility-based care.
"We commend Governor O'Malley for lending his voice to the protection of home healthcare services for one of our nation's most vulnerable senior populations and stand ready to work with him and Congress to keep costs low for patients who need skilled home health services," stated Eric Berger, CEO of the Partnership for Quality Home Healthcare. "We ask that Congress look beyond the re-imposition of a copay and instead advance Medicare reforms that protect patients, providers and taxpayers alike."
Targeted program integrity reform is a much more sustainable path to saving precious healthcare dollars while not placing an added burden onto seniors. Solutions such as the Skilled Home Health Integrity and Program Savings (SHHIPS) proposal stop wasteful Medicare spending and abuse by preventing the payment of aberrant claims, strengthening the claims review process, and improving conditions of participation standards. These targeted solutions stand to save billions without negatively impacting vulnerable beneficiaries.
Nearly 3.5 million seniors nationwide – including 56,000 in Maryland - receive the Medicare home health benefit, which is widely recognized as clinically advanced, cost effective and patient preferred.
SOURCE Partnership for Quality Home Healthcare