MedPAC Chairman Testifies at House Subcommittee Hearing on Medicare Benefit Design
NAHC Offers Written Testimony for the Record Opposing Home Health and Hospice Copays
April 12, 2013 09:44 AM
On April 11, 2013 MedPAC Chairman Glenn Hackbarth testified before the House Energy and Commerce Subcommittee on Health at a hearing entitled, “Strengthening Medicare for Seniors: Understanding the Challenges of Traditional Medicare's Benefit Design.” Mr. Hackbarth was the hearing’s only witness, and offered the Subcommittee members MedPAC’s perspective on Medicare’s benefit design – and particularly on proposed changes to cost sharing within the program.
Throughout the hearing, Subcommittee members asked Mr. Hackbarth about possible changes to Medicare’s plan design – including MedPAC’s recommendation to add a catastrophic cap on out-of-pocket costs, proposals for a universal deductible for parts A and B of Medicare, MedPAC’s suggestion to add a charge for supplemental Medicare (Medigap) policies, and general inquiries into whether or not Medicare’s benefits package was generous enough or too generous for current and future beneficiaries. Several members of the Subcommittee offered their support for a combined deductible for Parts A and B, while others asked about home health care specifically.
In an exchange with Congressman Jim Matheson (D-UT), Mr. Hackbarth emphasized that MedPAC believes that, “good home health care is an essential part of good quality care for Medicare beneficiaries.” His comments came in response to a line of questioning about access to home care services. Congressman Matheson suggested that reports of waste, fraud and abuse within Medicare’s home health benefit were isolated to certain areas of the country and most home health agencies – such as those in his home state of Utah – are, “doing the right thing.”
Andrea Devoti, Chairwoman of NAHC’s Board of Directors, submitted written testimony on behalf of NAHC detailing the organization’s opposition to proposals to impose home health and hospice copays. MedPAC has recommended a copay for home health episodes not preceded by a hospital or nursing home stay – and suggested that the amount be $150 per episode (5 percent of average cost). The Simpson-Bowles Commission recommended a uniform 20 percent copay for all Medicare services, including home health and hospice. This would amount to $600 to access an episode of home health care and an estimated $2000 to access the typical length of stay on hospice.
As a counter-measure to the increasing calls from some policy makers to shift more of the costs onto Medicare’s beneficiaries, NAHC’s testimony illustrates how copays can discourage use of necessary and beneficial care, stating that:
“Numerous studies have concluded that a copay can discourage use of necessary and beneficial care, resulting in the deterioration of a patient’s condition and ultimately leading to higher costs for the Medicare program through acute care interventions in higher cost settings. With hospice patients, barriers to comfort at the end of life add both avoidable costs and avoidable pain.”
In its testimony, NAHC offered proposals to strengthen Medicare program integrity as well as innovative ideas to expand the use of home care and hospice to ensure the delivery of high quality care at less cost to Medicare. NAHC remains committed to working with all members of the Energy and Commerce Health Subcommittee while opposing any attempts to impose cost-sharing measures that would restrict access to home care and hospice services. NAHC’s testimony will be included as part of the official record, and is also available online here.
All NAHC members are urged to contact their elected officials through NAHC’s Legislative Action Network and urge them to preserve access to vital home care and hospice services by opposing additional cuts and copays to such programs.
To get more information on yesterday’s Energy and Commerce Subcommittee on Health hearing – including the written testimony of Mr. Hackbarth and a background memorandum on the purpose of the hearing - please click here.