Stating Our Case

By the time you read this, the 2006 elections will be over, and the outcome will have a far-reaching impact on our industry.

In addition, CMS will have issued its final regulation on the new payment rules and method for home oxygen therapy, to be effective Jan. 1, 2007, and is about to issue the final rule on competitive bidding, scheduled to begin implementation in October 2007. Finally, news of whether CMS will improve the coverage and payment rules for power wheelchairs will be fresh off the press. Interesting times indeed.

With the sheer volume of Medicare policy changes affecting the major segments of our market, the question is how can we, in the longer term, change the perception of policy-makers to understand that home care is truly part of the solution? Keeping people with chronic or acute conditions out of institutions is not only patient preferred but, more important for policy-makers, it is far more cost-effective.

The answer is two-fold. First, as an industry we must devote resources to engage in a serious image campaign. Second, we need to work on developing objective and statistically valid data that provides substantive evidence that home care provides all the benefits we intuitively know; and then we need to communicate that information effectively.

In looking over the last few years, perhaps one of the greatest ironies we are faced with is the obvious contradiction between Medicare policies and payment cuts to home care and the efforts that a small number of states are pursuing that encourage greater use of home care. These few state programs are founded on the understanding that relying more on home health care than institutional care brings benefits to both the state's coffers and its citizens.

Data from these states can serve as the start of building a compelling case to demonstrate that not just states, but the federal government through the Medicare program, should change policies to gain similar significant cost and human benefits.

A program in the state of Vermont is probably the best example. Vermont is one of the first states to obtain approval from the federal government to offer home care as an option equal to nursing home care under Medicaid.