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In the various roles he has undertaken through the years, Val J. Halamandaris has been a singular driving force behind the policy and program initiatives resulting in the recognition of home health care as a viable alternative to institutionalization. His dedication to consumer advocacy, which enhances the quality of life and dignity of those receiving home health care, merits VNA HealthCare Group’s highest recognition and deepest respect. 

VNA HealthCare Group

I have the highest respect for them, especially for the nurses, aides and therapists, who devote their lives to caring for people with disabilities, the infirm and dying Americans.  There are few more noble professions.

President Barack Obama

Home health care agencies do such a wonderful job in this country helping people to be able to remain at home and allowing them to receive services

U.S. Senator Debbie Stabenow (D-MI) Chair, Democratic Steering and Outreach Committee

Home care is a combination of compassion and efficiency.  It is less expensive than institutional care...but at the same time it is a more caring, human, intimate experience, and therefore it has a greater human’s a big mistake not to try to maximize it and find ways to give people the home care option over either nursing homes, hospitals or other institutions

Former Speaker of the U.S. House of Representatives Newt Gingrich (R-GA)

Medicaid covers long-term care, but only for low-income families.  And Medicare only pays for care that is connected to a hospital discharge....our health care system must cover these vital services...[and] we should promote home-based care, which most people prefer, instead of the institutional care that we emphasize now.

Former U.S. Senator Majority Leader Tom Daschle (D-CD)

We need incentives to...keep people in home health care settings...It’s dramatically less expensive than long term care.

U.S. Senator John McCain (R-AZ)


Home care is clearly the wave of the future. It’s clearly where patients want to be cared for. I come from an ethnic family and when a member of our family is severely ill, we would never consider taking them to get institutional care. That’s true of many families for both cultural and financial reasons. If patients have a choice of where they want to be cared for, where it’s done the right way, they choose home.

Donna Shalala, former Secretary of Health and Human Services

A couple of years ago, I spent a little bit of time with the National Association for Home Care & Hospice and its president, Val J. Halamandaris, and I was just blown away. What impressed me so much was that they talked about what they do as opposed to just the strategies of how to deal with Washington or Sacramento or Albany or whatever the case may be. Val is a fanatic about care, and it comes through in every way known to mankind. It comes through in the speakers he invites to their events; it comes through in all the stuff he shares.

Tom Peters, author of In Search of Excellence

Val’s home care organization brings thousands of caregivers together into a dynamic organization that provides them with valuable resources and tools to be even better in their important work. He helps them build self-esteem, which leads to self-motivation.

Mike Vance, former Dean of Disney and author of Think Out of the Box

Val is one of the greatest advocates for seniors in America. He goes beyond the call of duty every time.

Arthur S. Flemming, former Secretary of Health, Education, and Welfare

Val has brought the problems, the challenges, and the opportunities out in the open for everyone to look at. He is a visionary pointing the direction for us. 

Margaret (Peg) Cushman, Professor of Nursing and former President of the Visiting Nurses Association

Although Val has chosen to stay in the background, he deserves much of the credit for what was accomplished both at the U.S. Senate Special Committee on Aging, where he was closely associated with me and at the House Select Committee on Aging, where he was Congressman Claude Pepper’s senior counsel and closest advisor. He put together more hearings on the subject of aging, wrote more reports, drafted more bills, and had more influence on the direction of events than anyone before him or since.

Frank E. Moss, former U.S. Senator

Val’s most important contribution is pulling together all elements of home health care and being able to organize and energize the people involved in the industry.

Frank E. Moss, former U.S. Senator

Anyone working on health care issues in Congress knows the name Val J. Halamandaris.

Kathleen Gardner Cravedi, former Staff Director of the House Select Committee on Aging

Without your untiring support and active participation, the voices of people advocating meaningful and compassionate health care reform may not have been heard by national leaders.

Michael Sullivan, Former Executive Director, Indiana Association for Home Care

All of us have been members of many organizations and NAHC is simply the best there is. NAHC aspires to excellence in every respect; its staff has been repeatedly honored as the best in Washington; the organization lives by the highest values and has demonstrated a passionate interest in the well-being of patients and providers.

Elaine Stephens, Director of Home Care of Steward Home Care/Steward Health Systems and former NAHC C

Home care increasingly is one of the basic building blocks in the developing system of long-term care.  On both economic and recuperative bases, home health care will continue to grow as an essential service for individuals, for families and for the community as a whole.

Former U.S. Senator Olympia Snowe (R-ME)

NCOA is excited to be part of this great event and honored to have such influential award winners in the field of aging.

National Council of Aging

Health care at home…is something we need more of, not less of.  Let us make a commitment to preventive and long-term care.  Let us encourage home care as an alternative to nursing homes and give folks a little help to have their parents there.

Former President Bill Clinton

NAHC Releases Statement Opposing Home Health Copay and Inflation Update Cuts in President's Budget

April 11, 2013 09:13 AM

The President’s FY2014 Budget released yesterday proposes to reduce Medicare and Medicaid spending by $400 billion over 10 years. The spending cuts in the proposed budget would hit almost every sector in healthcare, particularly pharmaceuticals, hospitals, and skilled nursing facilities. The President’s budget would replace the across-the-board cuts required by the sequester law.

The proposal includes a home health copay identical to the President’s proposal in September 2011 along with reduced Market Basket Index (inflation) updates in 2014 to 2023. The copay proposal would create a co-payment for new Medicare beneficiaries of $100 per home health episode, starting in 2017. Consistent with MedPAC recommendations, this co-payment would apply only for episodes with five or more visits not preceded by a hospital or inpatient post-acute stay. The budget estimates that the copay would reduce Medicare spending by $730 million through 2023.

The proposed update reductions of 1.1 percentage points each year for ten years would affect post-acute providers. Hospice is not affected. These reductions would be in addition to the 2014 home health rate rebasing and the productivity adjustments starting in 2015.

The proposal indicates that the payment update would not drop below zero. If that standard is applied, HHAs may face no cuts during the 4-year rebasing period since rebasing might bring the annual update to zero or below in 2014-2017 with an additional cut coming with an annual productivity adjustment (estimated about 1 percentage point) starting in 2015.

Medicare beneficiaries would pay a surcharge if they purchase private insurance that supplements Medicare coverage. The budget would also increase Part B and D Medicare premiums for high-income beneficiaries and increase the Part B deductible for new beneficiaries in 2017.

$20 billion of the Administration’s proposed savings would come through
Medicaid reforms, including:

  • Apply Medicare competitive bidding rates to Medicaid DME ($4.5 billion).
  • Rebase DSH payments in 2023 ($3.6 billion).
  • Improve drug rebates ($8.8 billion).
  • Waste, fraud, and abuse reductions ($3.7 billion)

In many respects, the President’s budget is a restatement of many of the Administration’s previous policy proposals. The budget will be just one of several proposals that Congress will consider in 2013. NAHC strongly opposes home health copays and any further cuts to home health payments -particularly with rebasing on the near horizon.

Early reaction to the budget proposal is that it is dead on arrival. That is usually the reaction when at least one house of Congress is held by the opposition party.

The National Association for Home Care & Hospice (NAHC) issued a strongly
worded statement opposing the Administration’s proposed home health copayments (a “sick tax”) and payment cuts.

NAHC President Val J. Halamandaris said that, “essential home health services are at risk. Previously enacted changes will cut Medicare spending on home health services by $77 billion over the next ten years - while less than $20 billion is spent annually. As a result of these cuts, 50 percent of all Medicare participating agencies will be under water in 2014 — that is, paid less than their costs by Medicare. Congress should therefore resist making additional cuts and imposing home health copays for any reason, including postponement or elimination of scheduled cuts in physician fees or for deficit reduction.” 

Halamandaris continued, “with regard to the reimbursement rates for doctors through Medicare, the home health community supports reforms that will stabilize Medicare payments to physicians. However, the costs of these reforms should not be funded by indiscriminate across the board cuts to home health care.”

To make the case against further home health cuts, the NAHC statement outlines the cuts that the Medicare home health benefit has already incurred:

  • Congress included $39.7 billion in home health payment cuts under the Patient Protection and Affordable Care Act (PPACA) through 2019. It reduced the home health inflation update one percentage point for 2011, 2012, and 2013, mandated rebasing of home health payment rates beginning in 2014 with a 4-year phase-in, and imposed a productivity adjustment in the inflation update beginning in 2015 that will reduce the inflation update by an estimated 1 percentage point each year. While home health represents about 5 percent of Medicare spending, it took a disproportionate 10 percent share of Medicare payment cuts used to pay for the Patient Protection and Affordable Care Act.
  • The Centers for Medicare and Medicaid Services (CMS) issued rules that cut home health payment rates by 2.75 percent in 2008, 2.75 percent in 2009, 2.75 percent in 2010, 3.79 percent in 2011, 3.79 percent in 2012, and 1.32 percent in 2013 — for total reductions of over 16 percent which was in addition to the PPACA rate cuts.
  • The Congressional Budget Office (CBO) recently revised its projection on Medicare home health spending, reducing it by over $32 billion to reflect the impact of legislative and regulatory cuts along with other factors.
  • As a result of sequestration, Congress’s agreement in August 2011 reducing the federal budget deficit, home health providers will take an additional 2 percent cut in payments in 2013, reducing projected home health spending by $6 billion dollars over ten years.

Halamandaris asserted that the proposed copay will not save $730 million as claimed by CBO.  “Studies have demonstrated that the opposite is true. A home health copay will take Medicare spending in the wrong direction -forcing patients out of high-quality, cost-effective care into much more costly care settings such as hospital, ER and assisted living-based treatment,” said Halamandaris.  “Health care that is cost effective for taxpayers, preferred by patients, and results in positive health outcomes should be encouraged and incentivized—not punished with additional payment cuts and a misguided “sick tax.”




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