Current Issues in Home Health and Hospice Advocacy

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  • Home Health Co-Payment: Co-payment proposals are short-sighted and will result in cost shifting to patients or increased institutional care. Compared to alternative care such as skilled nursing or a hospital stay, home health is a third of the cost. Without necessary home healthcare, patients will require healthcare in costly institutional settings – at much greater expense to government and families.


  • Home Health & Hospice Proposed Rule for 2013 (Members Only): On July 6, the Centers for Medicare and Medicaid Services (CMS) released its proposed home health rule that would take effect for calendar year 2013. Consistent with practice over the past few years, this proposed rule includes both the usual payment update proposals and an assortment of other changes to home health and hospice rules, ranging from trivial to very significant. 
  • Fraud and Abuse: VNAA in conjunction with its members developed a white paper consisting of proposals to reduce the incidence of abuse in the Medicare program and enhance the quality of care agencies provide. VNAA began this project anticipating that the growth in reported abuse of the Medicare home health benefit would require action and that VNAA could and should take a leadership position.
  • Rural Issues: VNAA has been very active on rural and underserved health issues over the past year and will continue to be active in the coming year through the formation of a new interest group focused on helping rural home health and hospice members’ access opportunities through agencies like the Health Resources and Services Administration (HRSA) as well as network with each other.
  • Hospice Payment Reform: Congress, the Medicare Payment Advisory Commission (MedPAC), the Centers for Medicare and Medicaid Services (CMS) and Congress are currently exploring reforms to the Medicare hospice payment methodology. Nonprofits have a unique mission-driven perspective to offer that focuses on quality and access for vulnerable patients.
  • VNAA Vulnerable Patient Study (Members Only): VNAA, in collaboration with the Center for Home Care Policy and Research of Visiting Nurse Services of New York, has completed a study that analyzed data on a range of patients that VNAA members treat and the costs associated with providing care to these patients