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InsiderOnline Blog: April 2014

If You Like Your Home Health Care …

Doug-Holtz Eakin points out one impact of ObamaCare that hasn’t been talked about enough, the arbitrary cuts to Medicare’s home health care benefit:

[The Center for Medicare and Medicaid Services (CMS)] has elected to cut Medicare funding for home healthcare by 14 percent over the next four years, ostensibly to pay for the Affordable Care Act. As a line item on a budget spreadsheet, this might seem reasonable. But in reality and as acknowledged by CMS, these cuts will drive approximately 40 percent of all home health agencies into the red by 2017– pushing agencies into bankruptcy, leading to layoffs of direct caregivers, and impacting the care seniors need. It is hardly surprising that earlier this month, the Labor Department reported 3,800 home health jobs were lost in February alone – the largest single-month job loss in the sector in more than ten years.

For decades, skilled home health care has been of great value to the Medicare program because it allows seniors to receive high-quality, coordinated health care in the lowest cost setting – the patient’s own home. Seniors who might otherwise require lengthy and expensive hospital stays or institutional care can receive skilled care for chronic conditions – an area that leaders in Congress have identified as needing improvement.

In addition to having more chronic conditions, home health patients are generally older and poorer than other Medicare populations, and therefore much more vulnerable to the negative consequences of a deep cut in their Medicare benefit. [The Hill, March 27]

ObamaCare gave CMS the option of cutting home health care by as much as 14 percent over four years, but it didn’t require it. The administration chose the deepest cut allowed by law, apparently in order to be able to say that ObamaCare is saving money. One way of controlling costs without arbitrarily cutting services that are vital to beneficiaries would be to transform the entire Medicare program into a defined-contribution, premium support plan that lets seniors decide where they get the best value for their health care dollars. That approach, laid out in The Heritage Foundation’s Saving the American Dream plan (see pages 17-23), wouldn’t put any particular health care provider, service, or delivery model out of business—unless the patients controlling the health care dollars decide they don’t provide enough value.

Posted on 04/25/14 04:48 PM by Alex Adrianson

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