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Medicare Cuts Will Cripple Home Health Agencies says Report

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madfloridian Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Sep-20-11 10:56 PM
Original message
Medicare Cuts Will Cripple Home Health Agencies says Report
Medicare Cuts Will Cripple Home Health Agencies says Report

The Centers for Medicare and Medicaid Services’ (CMS) proposed changes to the home health prospective payment system (HH PPS) would lead to negative Medicare financial margins for more than half of all home health agencies, according to National Association for Home Care & Hospice’s (NAHC) analysis of data in the proposal.

..."Large adjustments to home health payments will have a significant and alarming impact on the financial viability of home health providers, says NAHC, which could threaten access to a system of care that many seniors prefer.

CMS contended in its proposal that the adjustment was warranted because there has been limited change in patient acuity in the past few years, but NAHC countered by saying there is strong evidence showing patients to be sicker than ever and in need of the extensive care that has made care costs rise significantly.


NAHC says the CMS cuts are based on inaccurate information.

“Federal regulators have made assumptions regarding our patient population and patient acuity that do not accurately reflect the reality of home health care in America. As a result, their proposed payment adjustment is dangerously speculative and risks denying Medicare beneficiaries the care they need,” said Andrea Devoti, NAHC board chairwoman, in a statement."


Is anyone in the administration listening?

John Nichols has an article in The Nation this week.

The Devilish Detail of Obama's Speech: Deep Medicare, Medicaid Cuts

He praises the good in the proposed policy. He points out Obama wants wealthy Americans to pay more, and that is good.

He says that the president has rejected Paul Ryan's scheme for vouchers, and that he appears to have temporarily tabled the increase in age for Medicare.

Then he says:

But President Obama was still compromising with the Tea Party right when he delivered his remarks on Monday. Indeed, he proposed $580 billion in cuts to health and welfare programs, with $248 billion coming from Medicare and $72 billion from Medicaid.

That’s bad. Very bad.

The president would have us believe that the cuts can be made by addressing “waste, fraud and abuse.” The reality is that cutting a quarter-trillion dollars from Medicare will undermine the quality of care for seniors and the disabled. The Alliance for Quality Nursing Home Care estimates that Obama’s approach would lead to $42 billion in cuts for post-acute care providers “placing patients, our workforce and local facilities at risk.”

The proposed cuts to Medicare and Medicaid will put new stress on the economy by making it harder to maintain hiring levels at the skilled nursing facilities that have been some of the real job creators in a period of layoffs and rising unemployment rates.

The proposed Medicare and Medicaid cuts place new stresses on working families, many of which are already struggling to care for elderly and disabled relatives.


Another group, Alliance for Quality Nursing Home Care, expresses its disapproval and fears as well over the cuts.

Alliance Strongly Opposes President Obama's New Medicare, Medicaid Cuts

Noting that skilled nursing facilities (SNFs) provide high quality care to seniors while also benefiting taxpayers with cost efficient care delivery, the Alliance for Quality Nursing Home Care (The Alliance) today expressed strong opposition to President Obama's new $42 billion Medicare cuts over ten years directed at post-acute care providers, but expressed a desire to work collaboratively with the Administration to correctly rationalize and improve the nation's Medicare post-acute payment system. The combination of these new Medicare cuts, combined with other new Medicaid cuts, would undermine both the ongoing provision of quality care and the ability of America's second largest health facility employer to maintain its status as one of the few job growth sectors in a weak U.S. economy, said the Alliance.

"The new Medicare and Medicaid cuts proposed today - on top of the many cuts already in place -- would significantly compound the growing SNF sector instability placing patients, our workforce and local facilities at risk," observed Alan G Rosenbloom, President of the Alliance. "We will continue to point out that SNFs are already part of the solution to cost efficiency in the context of the deficit reduction discussion, and is key to maintaining quality care at a comparatively favorable price point. Further weakening our sector with more Medicare and Medicaid cuts is counterproductive to our nation's health care objectives."


These proposals prey on the most vulnerable in our society. They are shameful.

HealthCare Now has a way to urge the Super Committee to leave these programs alone. It is disgusting to me that they are being put back on the table so the committee's Tea Party extremists can tinker with them.

The debt ceiling package recently signed into law by President Obama created a Joint Select Committee on Deficit Reduction (Super Committee). This committee is tasked with identifying at least $1.2 trillion in cuts with the supposed goal of balancing the federal budget.

The creation of the Super Committee makes three of our country’s most vital safety net programs - Medicare, Medicaid, and Social Security - targets for cuts. But these programs are not the problem, they are the solution. Our social insurance programs keep people healthy and out of poverty, which is particularly important during times like these when so many people are experiencing economic hardship. Medicare, Medicaid, and Social Security should be strengthened, not cut. Medicare should be improved and extended to all.

The Super Committee needs to prioritize the preservation of Medicare, Medicaid, and Social Security and focus on finding a means of balancing the budget that doesn’t harm working families.


I have a funny feeling that no matter how outraged we are, no matter how much betrayal we feel....that no one is paying attention.

The "bipartisan" nature of DC now means that these serious cuts will occur. Those least able to stand up for themselves will feel the pain. The wealthy and powerful will barely feel any kind of discomfort at all.



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ProSense Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Sep-20-11 11:03 PM
Response to Original message
1. FYI
Alliance for Quality Nursing Home Care

<...>

The Alliance represents nursing home operators who want reduced federal regulation - and the Republicans who promise it.

<...>

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madfloridian Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Sep-20-11 11:13 PM
Response to Reply #1
2. Frankly, I don't care. In this case I agree with the groups.
So bring it on.

They are already making painful cuts, even doctors' offices are experiencing the pain already.

What is to come will harm our elderly.

So people can bring on their unrecs and their attempts to discredit me. Don't worry, I am so used to it. You should see the mail I get, my friend. Really ugly stuff.

The president is wrong on this one. You can admit it or you can choose to defend it. If you take the latter course you will end up feeling sheepish.

I have been there done that, and it was a relief to finally be honest about my misplaced confidence.
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Name removed Donating Member (0 posts) Send PM | Profile | Ignore Tue Sep-20-11 11:23 PM
Response to Reply #2
4. Deleted message
Message removed by moderator. Click here to review the message board rules.
 
madfloridian Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Sep-20-11 11:24 PM
Response to Reply #4
5. That group agrees with the other ones I quoted. The cuts will be dangerous.
So just keep it up. Whatever you need to do to defend the cuts, okay?

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joeglow3 Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Sep-20-11 11:51 PM
Response to Reply #4
8. Based on my experiences, it is true.
My wife works for an OB/GYN and they are in the process of phasing our their Medicare/Medicaid patients (i.e. they will not take any new ones and don't lift a finger to stop those who may want to move). They have determined that they lose money from most of them.

I also have a friend who is a physical therapist at a skilled extended stay rehab clinic. When their lease is up, they will be only renewing for half the building and will phase out medicare and medicaid for the same reasons. The idea that reducing reimbursement rates saves us money is finally being exposed for what it is: a stealth tax that raises all our healthcare costs and dis-proportionally affects the poor.
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Mojorabbit Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Sep-21-11 01:46 AM
Response to Reply #4
10. I am a retired nurse and I agree with the op.
I worked as a visiting nurse years ago. You really can help keep people in their homes and out of more expensive nursing homes with a lot of these programs. Hospice itself saves a gajillion dollars and is a godsend to dying people and their families. I am really stumped on why this particular branch of care was singled out. Perhaps there are some cuts that can be made but I can't see the extent of the cuts being talked about doing anything but harming the elderly and vulnerable.
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Mimosa Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Sep-21-11 04:48 AM
Response to Reply #10
16. Mojorabbit, I understand and agree
One of our most dear friends worked in your field for years in NOLA. After Katrina she moved to Chicago. We have kept in touch. She LOVES! her patients. But now she says the agencies are laying off experienced reliable nurses like her. :( It's because the government has cut back funds.

However, there is always money for wars and prisons, is there not? :(
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indepat Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Sep-21-11 10:53 AM
Response to Reply #10
19. Let the elderly and vulnerable die, just let 'em die is to shamefully implement a
fervent RW mantra. :patriot:
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Rex Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Sep-21-11 02:58 AM
Response to Reply #4
12. "The stuff in the OP is likely pure propaganda."
Likely, you mean you don't know for certain? No, of course not you just post garbage in garbage out like so many others. What good would actually knowing if the OPs position is valid or not, that won't matter to you.

I wish I could unrec a reply in a OP. :eyes:
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Mimosa Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Sep-21-11 04:44 AM
Response to Reply #2
15. Heck yes!
Madfloridian, I know a home healthcare nurse who really cares about her patients and has worked in the field for 15 years. She predicted this almost 2 years ago, and has been 'laid off'. She says many home care nurses are being laid off now. :(
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madrchsod Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Sep-20-11 11:35 PM
Response to Reply #1
6. what the hell does this have to do with cuts?
Edited on Tue Sep-20-11 11:36 PM by madrchsod
my wife works with special needs people who rely on medicaid and medicare. if these programs are cut these people will be even more in need of basic care and food. right now the agency she works for is getting it`s funding cut by the state of illinois.

the thought of a democratic governor and a democratic president would consider cutting money from these people is disgusting.
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Rex Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Sep-21-11 03:01 AM
Response to Reply #6
13. People like to blindly follow others without question.
Hence the reason it makes no sense and has nothing to do with the OP but is meant to distract.
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madfloridian Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Sep-20-11 11:16 PM
Response to Original message
3. This is a wrongheaded course for our party. All the unrecs won't change that.
All the arguments anyone can put up against this are just not going to cut it.



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jannyk Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Sep-20-11 11:41 PM
Response to Original message
7. K&R! To hell with the blue links!
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emilyg Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Sep-21-11 12:54 AM
Response to Original message
9. Thanks for posting.
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Wilms Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Sep-21-11 02:54 AM
Response to Original message
11. ^
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PhoenixAbove Donating Member (93 posts) Send PM | Profile | Ignore Wed Sep-21-11 04:32 AM
Response to Original message
14. K&R
Some here just don't want to understand the pain that is already being caused. I am afraid for what the future might bring.
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madfloridian Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Sep-21-11 10:38 AM
Response to Original message
17. New agency may cut even more?
Plus a 30% cut to doctors next year?

"Doctors also have reason to be concerned. Without endorsing any particular fix, Obama's plan assumes that Congress will address the main issue facing doctors: a scheduled 30 percent cut in Medicare payments next year due to a previous budget law gone awry. A solution being considered by congressional advisers would cut payments to specialists and freeze rates for primary care doctors.

Obama also wants to give additional authority to a new agency called the Independent Payment Advisory Board, which could force further cuts for medical providers.

All told, Obama's plan would cut Medicare by $248 billion over 10 years and squeeze another $72 billion from Medicaid. Some of Medicaid savings involve shifting costs to the states by rejiggering the federal payment formula and limiting a strategy currently used by states to draw more federal dollars.

Two leading organizations that supported Obama's health care overhaul law are expressing concerns about his latest plan. AARP says it could result in arbitrary cuts to Medicare. The liberal advocacy group Families USA says the Medicaid cuts could undermine coverage for the uninsured."

http://www.google.com/hostednews/ap/article/ALeqM5gaGO8pa7Fb_NOtgLz2Ks_kJQ3Iqw?docId=b954cb88d438483a94d0f3f6d47f75f4
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L0oniX Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Sep-21-11 10:42 AM
Response to Original message
18. One way or the other ...we are going to see old people kicked out in the streets ...and dying.
We live in a sick society.
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xchrom Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Sep-21-11 10:58 AM
Response to Original message
20. recommend
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Shireling Donating Member (222 posts) Send PM | Profile | Ignore Wed Sep-21-11 01:49 PM
Response to Original message
21. I think these cuts are terrible as well
I am REALLY hoping that the thought of taxing the rich is so appalling to the Republicans that this will just stall out, that we get more democrats back in the House and Senate, that we can re-elect Obama again, AND if this happens, that the DEMS will get off there butts and make some drastic, progressive changes during the last four years.

GOTTA HAVE HOPE.
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