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Save Medicare’s Home Health Benefit | Commentary

The Affordable Care Act was sold to the American public with the promise of improved access to health care for all who previously could not afford it. In a September 2013 speech on the ACA, President Barack Obama recalled examples of Americans he had met during his campaign who, because of financial obstacles, had to unfairly choose between their home and their health care.

And on this point, we agree. No American should be forced to decide between receiving quality health care and remaining in his or her home, especially America’s aging Medicare population.

Medicare’s home health benefit is a cost-effective program that protects seniors from having to make that difficult choice. Skilled health care services are allowing America’s most vulnerable senior and disabled individuals to access quality health care services in their home, which are proven to prevent expensive hospital readmissions and long-term care facility stays, which increase Medicare spending. Without access to home health, many more seniors will seek care in costlier care settings.

Despite these facts, the Centers for Medicare & Medicaid Services drastically cut funding to Medicare home health by 14 percent on Jan. 1 as part of the Affordable Care Act. This cut, despite promises that the ACA was intended to improve access to care for disadvantaged Americans, is putting Medicare’s most vulnerable patients and their home health providers at serious risk.

CMS has acknowledged that 2 out of every 5 home health agencies will become insolvent by 2017 because of the unprecedented 14 percent cut CMS chose to implement at the start of this year. Independent analyses of CMS data show that the 4 year, 3.5 percent annual rebasing cut puts more than 1.3 million sick and elderly home health patients at risk for losing access to home health care and nearly half a million Americans at risk of job loss.

In the first six months of this 48-month cut, negative consequences are starting to surface. Across the country, there are reports of home health agency closures, consolidations and layoffs, disrupting the lives of vulnerable patients and hard-working home health professionals.

Upon hearing these stories, we came together to find a solution that can better protect access to home health care for the 3.5 million Medicare patients nationwide who depend on home health today and improve the benefit for the millions of seniors who will require home health in the future.

The Securing Access Via Excellence (SAVE) Medicare Home Health Act will do just that.

First, the SAVE Medicare Home Health Act will repeal the arbitrary, across-the-board 3.5 percent per year cut for years 2015, 2016 and 2017 and replace them with sustainable reforms that will achieve savings by improving care for Medicare beneficiaries and reducing avoidable spending. To achieve savings the legislation will establish a value-based purchasing program for the Medicare home health benefit to better incentivize home health care agencies to deliver high-quality care to beneficiaries and reduce hospital readmission rates.

It will further increase transparency in the delivery of home health by making providers more accountable for care quality and making home health agency performance data more accessible to the American people.

The SAVE Medicare Home Health Act is designed to be budget neutral, however we believe it is well positioned to save Medicare dollars over the long term. While the bill adjusts payments in an amount equal to the 3.5 percent annual rebasing cut, incentive programs to ensure that patients remain in their home will lead to fewer hospital admissions, therefore achieving greater Medicare savings.

Last, the SAVE Medicare Home Health Act requires the secretary of Health and Human Services to conduct the detailed 4 year analysis of the 14 percent rebasing cut required under the Section 3131 of the Affordable Care Act, which was not completed before the implementation of the ACA cut on Jan. 1.

The SAVE Medicare Home Health Act is a viable, patient-centered approach to reducing Medicare spending, which warrants serious consideration by Congress. We hope our colleagues will agree that the choice between home and quality health care is one no American should ever face.

Rep. Greg Walden is a Republican representing Oregon’s 2nd District. Rep. Tom Price is a Republican representing Georgia’s 6th District.

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