Home Care Patients Worry Over Possible Cuts (They should)

[Thickasabrick]

We all need to make sure this does not happen! Write your congress critters.

Home care shows, in microcosm, a conundrum at the heart of the health care debate. Lawmakers have decided that most of the money to cover the uninsured should come from the health care system itself. This raises the question: Can health care providers reduce costs without slashing services?

Under the legislation, home care would absorb a disproportionate share of the cuts. It currently accounts for 3.7 percent of the Medicare budget, but would absorb 10.2 percent of the savings squeezed from Medicare by the House bill and 9.4 percent of savings in the Senate bill, the Congressional Budget Office says.

The House bill would slice $55 billion over 10 years from projected Medicare spending on home health services, while the Senate bill would take $43 billion.

Democratic leaders in the Senate and the House justify the proposed cuts in almost identical terms. “These payment reductions will not adversely affect access to care,” but will bring payments in line with costs, the House Ways and Means Committee said. The Senate Finance Committee said the changes would encourage home care workers to become more productive.

The proposed cuts appear to be at odds with other provisions of the giant health care bills. A major goal of those bills is to reduce the readmission of Medicare patients to hospitals. Medicare patients say that is exactly what home care does.

“It helps me be independent,” said Mildred A. Carkin, 77, of Patten, Me., as a visiting nurse changed the dressing on a gaping wound in her right leg, a complication of knee replacement surgery. “It’s cheaper to care for us at home than to stick us in a nursing home or even a hospital.”

Delmer A. Wilcox, 89, of Caribou, lives alone, is losing his vision, uses a walker and has chronic diseases of the lungs, heart and kidneys. He said his condition would deteriorate quickly without the regular visits he received from Visiting Nurses of Aroostook, a unit of Eastern Maine Home Care.

The Aroostook County home care agency, which lost $190,000 on total revenues of $1.9 million in the year that ended Sept. 30, estimates that it would lose an additional $313,000 in the first year of the House bill and $237,000 under the Senate bill.

The prospect of such cuts has alarmed patients and home care workers.

Home health care keeps people out of nursing homes and hospitals - I would hope that we would be able to encourage more home health care as opposed to less.

Whole Article: http://prescriptions.blogs.nytimes.com/2009/12/04/home-care-patients-worry-over-possible-cuts/

[ChazII]

1. Nurses come to tend to my father

3 times a week. I do not know what I would have done without them, especially in the post op days.

[laughingliberal]

2. Home health has had a target on its back since the Clinton years

It has been shown over and over to save money by preventing hospitalizations and readmissions. The problem is they do not have huge profits and lots of money to lobby Congress for their interests as the hospital corporations do. So, whenever they start talking cuts to Medicare or rooting out 'waste, fraud, and abuse, look for home health to bear the brunt of it. It's tragic but it's true.

[RKP5637]

3. USA, Inc., People come last! n/t

[slipslidingaway]

4. And just wait til the boomers begin to retire in 2 years and the number...

of people on Medicare rises dramatically over the next two decades.


"...Under the legislation, home care would absorb a disproportionate share of the cuts. It currently accounts for 3.7 percent of the Medicare budget, but would absorb 10.2 percent of the savings squeezed from Medicare by the House bill and 9.4 percent of savings in the Senate bill, the Congressional Budget Office says.

The House bill would slice $55 billion over 10 years from projected Medicare spending on home health services, while the Senate bill would take $43 billion..."

[Thickasabrick]

5. One of my senators is Kay Hagan and I'm afraid she's going to vote

no to the whole bill so I'm somewhat leery of sending her this to give her another excuse. My other senator is an asshole puke who will vote no for sure. But this is really crazy - if they truly wanted to keep costs down why would they cut so much of this? I'm glad this came out when it did anyway.

[slipslidingaway]

11. Republicans have been mentioning the additional Medicare cuts...

during the debate, one example below. I've said for months that it just does not make sense to me. That any savings will be needed to offset all the boomers enrolling in Medicare over the next two decades, from 46 million to 79 million people. I have not heard anyone explain how those increased costs in Medicare will be paid for???


http://www.c-spanvideo.org/congress/?q=node/77531&id=9069532

Mr. KYL...

"...The first answer to who pays is, it is America's seniors, because about half of the cost of the bill is allegedly paid for by cuts to Medicare.

Let me break down a little bit more specifically than the Republican leader did exactly what that means. This is about $500 billion in Medicare cuts as follows: $137.5 billion from hospitals who treat seniors; $120 billion from Medicare Advantage, which is the insurance program that provides benefits to seniors which will be cut more than in half as a result of this $120 billion reduction; $14.6 billion from nursing homes that treat seniors; $42.1 billion from home health care for seniors; and
$7.7 billion from hospice care, one of the most cruel cuts of all.

Obviously, with cut this dramatic there is no way to avoid jeopardizing the care seniors now enjoy, and seniors know this..."

[madrchsod]

7. good luck cutting homecare dickwads

we are retiring and there`s a shit load of us that don`t buy this bullshit. i have no idea what world these people live in but our parents and grandparents lived the rest of their lives in their homes until it was impossible for them. do they think the largest active voting block is going to take this?

they are sadly mistaken if they think they will get away with cutting anything that has to do with medicare.

[Thickasabrick]

9. LOL....I'm right there with ya!! nt

[slipslidingaway]

13. But so many people want this bill to pass and the Medicare savings...

to help finance this bill. That just does not make sense, as the largest vote block moves to Medicare.

At the same time money will be needed to pay back the SS Trust fund.

:shrug:


And then we need money for wars.

:puke:

[madrchsod]

6. there is`t any "savings" by cutting these programs

anyone with a brain knows that. money talks even if means people dieing with out dignity

[RKP5637]

8. I don't look forward to very pleasant years when older in this country. This is not

a country for people. Citizens are in the way. USA. Inc.

[bobbolink]

10. Its all that "ProLife" protection, donchaknow.

:nuke:

[eilen]

12. I just quit my homecare job

the productivity demands along with the ever increasing paperwork and expectations of Medicare killed it for me. Next week is my last week. Our agency has been losing money the last two quarters and they keep pointing at us nurses instead of looking at the administrative bloat. Why so many administrators? To keep on top of all the documentation demands and compliance issues that is thrown at us with every state review. Gov. Paterson has instituted a gross receipts tax that taxes us on our gross receipts from Medicare and Medicaid. If we are missing anything, they take back or charge back the fees for episodes. We have to be careful we put the correct top 3 diagnoses in the "bucket" because that too effects compensation. Medicare no longer pays per visit, they pay per "episode" and are coming out with a new Oasis (Medicare assessment and tracking tool) starting Jan that all the admins are busy trying to train everyone on. It kind of burns me that they are so concerned a home health aide might be skipping out on a 2 hour shift but we can pour money down AIG's throat like a beer bong and not care where it went.

We see about 50/50 medicare and medicaid and a good amount of charity cases. We have a long term care program (nursing home without walls) and provide free social work and nutritional consults for those patients that need them. The agency I'm leaving has been in business since 1895. The accountant is beyond frustrated with the task of making the ends meet.

Homecare nursing is like burning the candle at both ends. I'm too old for that so I'm going back to the hospital where I hand off my patients at report and am not expected to work on them after I get home.

[Thickasabrick]

14. Update - republican amendment to remove the home health care

cuts was defeated. Maybe someone knows the democratic plan as to where that money will come from since we need more home health care available to people? I am sure there is a good reason for this, I just don't know what it is.