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Madfloridian's Journal
Posted by madfloridian in General Discussion
Tue Sep 20th 2011, 11:56 PM
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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