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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

Nation’s Home Health Organizations Host News Conference on Rebasing

August 30, 2013 01:46 PM

The National Association for Home Care & Hospice (NAHC), Visiting Nurses Association of America (VNAA) and the Partnership for Quality Home Healthcare (PQHH) held a joint news conference recently where leaders of the three organizations – representing all aspects of the home healthcare community – demonstrated their unified opposition to CMS’ proposed rebasing rules that would dramatically cut funding to home healthcare under Medicare and significantly limit access to such services to beneficiaries.

The news conference was organized by NAHC and included participants from the other two organizations including NAHC President Val J. Halamandaris of NAHC, Chairman Billy Tauzin and Eric Berger of PQHH and Tracey Moorhead of VNAA – all of whom expresses their organization’s staunch opposition to the proposed rebasing rules.

Among the media outlets that participated were: Inside Health Policy; Kaiser Health News; Reuters; BNA; Home Health Care News; SeniorCare News ; Detroit Regional News Hub; Infinite Communication.

The call started with introductory remarks by Bill Tauzin, who stated that the home care community’s “collective concern is that any further cuts to Medicare home health will endanger seniors’ and disabled individuals’ access to the clinically-advanced and cost-effective, home-based care that is medically necessary for homebound patients… Cuts to the popular home health benefit pose serious risk to one of the nation’s most vulnerable populations, and therefore must be prevented.”

After giving an overview of the topics that were going to be discussed during the call, Mr. Tauzin then introduced NAHC’s president, Val J. Halamandaris, stating that, “Val has been leading the home health sector for more than 30 years and can offer a unique perspective into the unprecedented level of cuts we face today.”

Mr. Halamandaris focused his comments on the value, history and purpose of the home health benefit, stating that:

“Nearly 3.5 million seniors and disabled individuals depend on the Medicare home health benefit for skilled nursing care, physical therapy, speech-language pathology, and occupational therapy services…

Skilled healthcare services that were once only available to Medicare patients in a facility-based setting can now be safely and efficiently delivered in a patient’s home – at a lower cost to the Medicare program than other care settings…

A recent analysis of Medicare claims data strongly suggests that the clinically appropriate use of skilled home healthcare by America’s seniors can lead to significant savings to the Medicare program by reducing hospital admissions, improving chronic disease management and strengthening care coordination…

During my 30 years at NAHC, I have rarely seen a time when our sector was subject to such dramatic funding cuts... 

In recent years, it seems that we are targeted time and again when Congress looks to trim the Medicare program.  Just since 2009, Medicare home health payments have been cut by an astonishing $72.5 billion.  The prospect of another $22 billion in cuts is honestly mind-boggling…

The proposition of even more cuts to Medicare payments for cost-effective and patient preferred home care is especially troubling considering the value of home health and the increased patient need on the horizon…

Home healthcare providers must be poised to meet the growing demand that will result from the dramatic flood of Medicare patients entering the Medicare program…

Estimates suggest that approximately 10,000 Baby Boomers turn 65 and become Medicare eligible each day in America…

This is no way to run a business, but more importantly, this is no way to take care of our nation’s most frail and vulnerable patients.  It’s just not right.

Mr. Halamandaris concluded his comments before introducing Tracey Moorhead of the Visiting Nurse’s Association of America by stating plainly that, “if home health agencies are forced to close – especially in rural areas – homebound patients may be forced to leave their home and seek care in a more expensive nursing home or hospital.”

At issue is the issue of rebasing home health payments under Medicare. In CMS’ proposed HHPPS rule - issued June 27 - CMS proposes to further reduce Medicare home health funding by instituting a rebasing rate set at the maximum level permitted by law – 3.5 percent annually from 2014 to 2017 – totaling a 14 percent cut over the next four years.  Analysis of the proposed rule reveals that a 14 percent reduction in home health reimbursement would result in a cut of $22 billion over 10 years.

When the proposed cuts under CMS’ rebasing proposal are coupled with the $72.5 billion in Medicare home health funding that has been cut since 2009 due to a series of legislative and regulatory changes, the nation’s home health sector is facing a total cut of nearly $100 billion. 

If finalized and implemented as proposed, the cuts to home healthcare providers through rebasing is projected to impose net operating losses on 47 of the 50 states and the District of Columbia by 2017 - rendering many home health agencies inoperable.  Nationally, the Medicare home health margin will drop to -9.77 percent.

In her comments, VNAA’s president and CEO Tracy Moorland stated that:

“The proposed rebasing policy only further reduces the sufficient payments needed to ensure that vulnerable patient populations retain access to quality home health services…

Likewise, underserved areas are also at high risk when Medicare payments are cut. Vulnerable populations – especially those who are dually eligible under Medicare and Medicaid and those living in geographical areas that are underserved – have limited access to home health and more cuts only further threaten patient access in these communities…

Any changes to the home health benefit must take into account these factors or risk putting these vulnerable patient populations at an even greater disadvantage for accessing the home healthcare they desperately need.”

Before introducing Eric Berger from PQHH, Ms. Moorland concluded that Medicare cuts, “directly threaten the ability of…smaller agencies to stay open, retain staff and provide adequate pay to their home health professionals.  The reality is that many small and independent home health agencies will have to make the difficult decision to shut their doors if these deep cuts take effect.”

Mr. Berger of the Partnership for Quality Home Healthcare reiterated that:

“The new analysis shows that the rebasing cut would translate to another $22 billion in cuts over a decade.  If coupled with previous cuts – a total of $72.5 billion made since 2009 – home health would experience an unprecedented cut of $94.5 billion from 2011-2020. These proposed cuts are unsustainable and completely undermine the ability of our sector to provide quality healthcare services to the nation’s most vulnerable patient populations.”

In wrapping up his remarks, Mr. Berger spoke for the whole home care community by stating:

“Our organizations have come together around this issue to ensure that both the Administration and Congress fully understand the enormity of this situation and what these cuts would mean to their constituents and the future of our home health sector.  The sustainability of home health delivery in America is dependent on protecting our community from this 14 percent cut and the consequences it bears.”

NAHC members are encouraged to contact their lawmakers and urge them to preserve access to home health care by opposing such rate cuts.

To read the full press release that accompanied the news conference, please click here.

To view a video on rebasing by NAHC President Val J. Halamandaris, please click here.

To read the previous NAHC Report articles on rebasing, please click here.




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