New MC should I change to VA?

[twokidsmom,rn]

Hi

I am new one month to HH. I am a RN case manager for a small company that has 7 offices. Found out today that the gov't is decreasing Medicare payments for HH is being reduced by $200.00/case starting in 2011. Also will need to have pt see MD within 2 weeks after HH start up.

My old boss from the VA called me offered me a night position of 12 hr shifts, I was doing 5 eights which was too much and no life. With these decreases in HH I am nervous about the future of HH and working for a smaller company. I know the VA is not going anywhere.

I like HH so far still getting use to paperwork and organization, have been seeing 5 or less a day worried it will just get less and less.

Any advise

[KateRN1]

I don't think that the reduction in reimbursement rates will affect much except for utilization rates and better accounting of supplies. Every time changes are made in reimbursements, from back in the days before PPS, there's an outcry of "how will we make it" but in reality, we need to work smarter, not harder. $200 per episode amounts to a reduction of less than the payment for 2 skilled nursing visits, so I really don't see this impacting the amount of cases available. On the contrary, as our Baby Boomers grow older, the demand for home health care will rise in all areas--Medicare, private pay, and Medicaid waiver programs--as elders want and insist on aging in place. We have fewer projected caregivers per capita than we have aging boomers, so I really don't see a problem for the future of home health. I see a growth explosion in the works, but agencies that work smarter will be the ones to fare the best, with the implementation of EMRs, telehealth monitoring, and use of technology. Home health, now more than ever, is the wave of the future. Inpatient costs far exceed home care

costs and now more patients are being sent home sicker than ever, with far more complicated needs than ever before. If you enjoy home care and have a handle on it (as much as one can have one month in), I would advise you to stick around. You might be surprised.