20 % Pay Cut for Ohio Independent Providers

U.S.A. Ohio

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Any Ohio IP nurses out there? Just wondering what your thoughts are about our wages being cut by 20%. For homecare agencies their 1st hour is only being cut by 5%, while our 1st hour is being cut by 20% for doing the same work. Then for every hour after the 1st hour, agency will keep their full pay rate. Every hour after the 1st hour for independent providers will be cut by 20%, so agencies can continue to receive their full rate!

Anyone else feel the state is trying to get rid of us? 20%.....hmmn!

For Agency: (1) Effective October 1, 2011, reduce the medicaid program's first-hour-unit price for aide services to ninety-seven per cent of the price paid on June 30, 2011, and for nursing services to ninety-five percent of the price paid on June 30, 2011;

For Independent Providers: (2) Effective October 1, 2011, pay for a service that is an aide service or a nursing service provided by an independent provider eighty percent of the price it pays for the same service provided by a provider that is not an independent provider.

Oh, this was called "Victory for Home Care"

"The administration was able to reduce the cuts for agencies by reducing the rates paid to independent providers. Aside from receiving the 5% and 3% cuts on first hours for nurses and aides respectively, all Independent Providers will receive 20% less than the price paid to home care agencies, on the first hour and subsequent unit rates. The funds saved by this reduction will be used by the state to offset the cuts that were proposed for the first hour rates."

As independent provider nurses we do the same work, but yet we will no longer be receiving the same pay as agency. Anyone else out there think something is going on?

Specializes in Home Healthcare.
I am going to hang in as long as possible, and if I thought forming a coalition of nurses against kasich would help, I would surely rally on our behalf.

We certainly need something, that will bring attention to what is going on within the Ohio Home Care Program. I wish a news reporter would confront them with the cameras rolling as to why this drastic pay cut 20% for IP nurses in order to avoid a drastic pay cut to agencies. Why did they not cut the pay of IPs and Agencies equally? I would sure like to hear their response and justifications.

A coalition of nurses against Kasich may help.

You are right, all cuts should be made lateral, across the board, if any at all. My patient's family today that I spoke to had NO idea what was going on. They were shocked.

All I can say is.. a change is a comin.. I am still confused about the actual decrease in pay. so 20 percent every hour, right? There are so many different stories. .. lol

How about this new "pay for service"? As it is being described to us by our nurse manager, if our patients don't rate our service (friendliness of nurses, receive help as soon as you want it, etc.) as "always" blah, blah, blah...we won't get paid. The examples we are being given are that if a patient is called for a survey and the answer that the nurses were "usually" friendly, and not "always" friendly, we don't get paid. Or, if the nurses don't "always" explain all information about drugs, maybe the patient says "usually", we don't get paid. Would this fly if I walked into a McDonald's and said, "Your clerk here didn't smile at me the way I wanted her to smile at me. I'm not paying for my Big Mac"?

i hope you can provide more details. What if a nurse is on a mandatory double shift and is tired? Exhausted from the code she just led and distraught that the patient was basically flogged and then died anyway?

I think it's time for a little clarification here for you and your colleagues. Stat.

Specializes in Home Healthcare.
All I can say is.. a change is a comin.. I am still confused about the actual decrease in pay. so 20 percent every hour, right? There are so many different stories. .. lol

I know what you mean.....I have seen all the different stories on the 20% pay reduction depending what website you are looking at. As usual it has become confusing for IPs. Have you been able to find this in ODJFS Emanuals updates? If you find it, please let me know. I searched and searched....maybe I missed it.

One website that is run by an Ohio IP has documented there will not be a 20% decrease in the reimbursement amount for subsequent hours worked. However, if you go to the Midwest Care Alliance website, who I trust as a source of accurate and honest info, they have clearly stated "Rates to Independent Providers (IPs) were also cut and took the brunt of the impact in the home care arena as they will receive 20% less than the price paid to home care agencies on the first hour and subsequent unit rates. When calculating the "new" home care first hour rate this essentially creates a loss of income to IPs of 24%. This cut helped lessen the reduction to home care agencies that was originally proposed. At the moment this is a victory for agencies that have seen eroding opportunities for services that go to IPs."

They have a phone number and email address they can be contacted at.

How about this new "pay for service"? As it is being described to us by our nurse manager, if our patients don't rate our service (friendliness of nurses, receive help as soon as you want it, etc.) as "always" blah, blah, blah...we won't get paid. The examples we are being given are that if a patient is called for a survey and the answer that the nurses were "usually" friendly, and not "always" friendly, we don't get paid. Or, if the nurses don't "always" explain all information about drugs, maybe the patient says "usually", we don't get paid. Would this fly if I walked into a McDonald's and said, "Your clerk here didn't smile at me the way I wanted her to smile at me. I'm not paying for my Big Mac"?

This sounds like a twist on the Pay for Performance that we are dealing with in Home Health. The problem is, it sounds subjective. Some patients will never be satisfied, ever. They are miserable in their lives and just take it out on us. I had a patient once who was a quad, he was the most miserable unhappy creature on God's Earth. He never had a good thing to say, ever. Every visit was torture. I am sure he would have rated us poorly no matter what. Another patient I had hated women. He was always drunk and abusive. We had to see him every day for years. It made you want to weep when you saw him on your assignment. He definitely would never have rated us highly.

Satisfaction surveys are being increasingly looked at as a desired outcome by payer sources. But in true pay for performance you get more pay for higher performance (bonus), and less pay for poor perfomance (reduction). Most groups will fall in the middle and get baseline pay. It is an incentive to achieve excellence. They cannot "not" pay you. That makes no sense. I suspect that someone is misinterpreting this information.

Thanks for the info.. originally, DYSERV, a billing service for waiver, said only cut was 1st hr. Its driving me crazy. I have a child in college, one graduating, mortgage, food, etc. I am sure everyone has bills, kids, etc. . its not only me. I am still so sad for our patients. I am at this point trying to find ways to cut my expenses so I can still hang on.

Specializes in Home Healthcare.
Thanks for the info.. originally, DYSERV, a billing service for waiver, said only cut was 1st hr. Its driving me crazy.

My billing company told me, it was the 1st hour and subsequent units. I received a forwarded email from my billing company, that they had received, where it was stated:

"Aside from receiving the 5% and 3% cuts on first hours for nurses and aides respectively, all Independent Providers will receive 20% less than the price paid to home care agencies, on the first hour and subsequent unit rates. The funds saved by this reduction will be used by the state to offset the cuts that were proposed for the first hour rates."

Just so you know, the ones who announced "Victory for Home Care!" do not have this statement that they released above on their website word-for-word any longer. The part about independent providers is left out. Maybe tomorrow, a different statement will be posted. LOL

I am going to make a few calls in the morning and find out for sure what is going on. I will send you a private email. I am really surprized there does not seem to be much interest or thoughts from other IP nurses. I did hear, that many were leaving the program, which is sad for them and the consumers. I am hoping it is just a rumor.

Why do they want Agency only ?

Specializes in LTC and Homecare.

I am glad I finally had the time to sign up on this site and speak my mind! I am confused about the 20 % pay cut. My billing co. told me it was 20 % for the first and every hr. Then I hear from other nurses who talked to their billing companies they were told it was for only the loading hr. Does the right hand know what the left is doing? My question is why weren't we sent notices about the pay cut to our ohiohcp page? katnursey is correct in saying it depends on the website you are looking at.

Information is being posted differently and IPS are all being told different information.. If I should hear anything I will let you all know. Isn't this the way it has always been for us?! A confusing mess time after time.....we are always the last to know what is going on.

I have 2 teenagers to support. 20 % is a lot for me to lose. I love working as a independent nurse but will have to work at the nursing home full-time where I currently work at PRN. I have already talked with the D.O.N about this.

I read where the 20 % pay cut to IPS and not to agencies is because they have rent to pay and overhead costs that we do not have. This is not true!! I have rent to pay, a car payment, 2 kids to support, overhead costs too, etc. We all do. There is only maybe 1,000 IPS or so left in Ohio, so they cut our pay by 20 %, when Kasich could have surely balanced his budget much easier by increasing the agencies pay cuts more. This should have been a equal cut for all. Do you realize how many agencies there are in Ohio? The statement made taking 20 % from IPS so agencies would not suffer a pay cut like us is idiotic. Yes, I do believe they are going to eliminate us one by one. The clients/patients/consumers will suffer from this. Did they think about the consumers when they posted their VICTORY statement and sent emails out about it? To actually brag how they were involved and secured relief for the agencies was in poor taste.

I am totally disgusted.

Specializes in LTC and Homecare.
"the Home Care Waiver Program created us to provide services" because why---The Government is God-like? The Lord, er, Government giveth and the Govt. taketh away. If you look back, IPs were probably enlisted to solve a problem of even finding providers willing to serve these clients and also to save money over home care agencies. So why change now? Because they CAN. It's the politics of the Mailed Fist.

You are 100 % correct. IPS solved their problem. The agencies whined about it. I worked for a agency a few years ago for about 6-7 months. I was told consumers should not be able to request services from independent providers only!! Well that right could not be taken away from the waiver consumers so instead they are taking our pay away from us to eliminate us, one by one. I would like to know what other group of nurses in Ohio did Kasich cut 20 % from??! NONE

We Need TO Let Everyone know that there is going to be a hearing on this on AUGUST 15th More info to follow. I bet many do not even know that the cuts are going to happen in October 2011

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