Cuts to Medicare: What impact on HH?

[Mijourney]

I understand that for the next federal budget that there are going to be cuts to HH. What will be the impact or fallout from this? Your feedback is appreciated.

[steelcityrn, RN]

From what I have been told, they are going to start reimbursments based on outcomes. Basically, if your company if not run very efficiently with the nurses, physical therapist and O.T.'s providing the best of care with no waste of time or money, you may survive the cuts. OH, and its going to get ugly!

[NRSKarenRN, BSN, RN]

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[ohioln, RN]

I was told by my agency that the ODJFS in OH is going to try to cut reimbursement for all skilled nurses by hourly decrease 1st 2 hrs, which is to effect home care nurses most, (RN, LPN) because each visit we do is counted as the first hour (ex: decrease: 0.8 1st hr, 0.5 2nd hr) There is going to be a meeting this April in Columbus OH, and we were told that writing and going there on that day (I don't know what day it is) will be most effective.

[lorster]

I was a home health nurse until about 96 during the time when home health was seeing some serious cut backs. It drove me back into hospital nursing as there just was not enough work to keep me busy 40 hours a week. A day has not gone by that I don't miss it. It is the best thing since bread and butter. I now work med surg and I see so many patients here that could benefit with home health but services are just not available. Medicare does not mind spending thousands of dollars letting a patient sit in the hospital only to get a daily dose of Levequin. That patient could be home, getting the dose from home health with medicare funding the Levequin, and not being exposed to nosocomial infections. I just do not understand medicare mentality. Things need to change.

[Mijourney]

From NRSKaren's posting, one can see that Medicare and Medicaid are very complex animals indeed. Maybe I'm wrong for thinking this, but it irritates me that HH care is thrown in with LTC which means it has to fiercely compete with institutional services for LTC funding (the nursing home lobby has a lock in my state). Now, all funding is going to be cut and HH care is no better off for it. I think HH care should be its own entity due to its uniqueness.

HHAs are going to have to do a better job of proving themselves. I still find that there are a few of us mismanaging our visits with our clients. The visits are inefficient and ineffective. However, in the long run, HH care is shown to be more cost effective with more quality than a nursing home. This is where the dollars should follow.

[homehealth43130]

NAHC has been working to get the freeze out of next years budget for Medicare - they recommend that you call your congressman/congresswoman and let them know your opinion. The more voice we have as a home care community the more the legislature will have to listen to us.