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National Association for Home Care & Hospice
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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 March on the Capitol Seeks Relief from CMS Rebasing Rule through a Legislative Amendment and Protection from Further Cuts and Copays

December 10, 2013 09:47 AM

NAHC is encouraging all of its members to participate in a March on the Capitol, either in person or virtually, to highlight issues surrounding access to home care and hospice, including Medicare home health rebasing relief and protecting home care and hospice from further payment cuts and copays. For more information, please see NAHC Report December 5, 2013. 

NAHC and the Forum of State Associations have set the March on the Capitol for December 11, 2013, to coincide with expected legislative action this week on the SGR or "Doc Fix" and next year’s budget.

NAHC seeks to secure relief from the recently issued Medicare rebased rates through a proposed legislative amendment and ensure that home care and hospice are exempted from any further cuts or copays. Those unable to attend in person are urged to participate virtually by sending messages to their elected officials asking them to:

  1. Postpone implementation of the rebasing rule and require CMS to reconsider the rule and set payment rates that ensure access to home health care services (Letter Template Here), and
  2. Reject any proposal to use home health (Letter Template Here) or hospice (Letter Template Here) payment cuts or copays as a means to offset the cost of fixing the Medicare physician payment formula, for deficit reduction, or other purposes.

To contact Congressional offices by phone, you may obtain contact information here.  Ask the receptionist to connect you with the staffer who handles Medicare issues.

Following is a description of the proposed rebasing amendment, along with talking points in support of rebasing relief.

Where Things Stand with Respect to Rebasing:

  • The Centers for Medicare and Medicaid Services (CMS) released the Home Health Prospective Payment System (HHPPS) Final Rule on Friday, November 22nd. The rule is effective beginning January 1, 2014.
  • The Final Rule unnecessarily rebases payment rates at the maximum cut permitted under the Affordable Care Act: a cut of -3.5% per year over each of the next 4 years, totaling an unprecedented cut to Medicare home health funding of 14% by 2017.
  • This rule disregards appeals made by hundreds of lawmakers, dozens of stakeholders among beneficiary advocacy organizations (including AARP), and tens of thousands of seniors and caregivers.

Why Action is Needed:

  • CMS’s rebasing cut directly affects the 3.5 million homebound seniors and persons with permanent disabilities who use home health care annually. These vulnerable citizens are older, sicker, poorer and more likely to be a minority than the typical Medicare beneficiary.
  • CMS acknowledges that “approximately 43 percent” of all Medicare home health providers will be paid less than the cost of care by CY 2017.No previous Medicare rule has ever had such an impact on nearly half of a health care sector.
  • In reality, CMS is actually underestimating the devastating impact of these cuts on providers over the next 4 years. Based on recent cost and revenue trends, it is more realistic to expect that 72.9% of providers will be paid less than their costs by 2017. To reach its projection, CMS must assume that providers can completely absorb the 14% rate cut without any financial consequences, an assumption that is in conflict with actual experience in 2011, 2012, and 2013 when rate cuts significantly reduced Medicare margins.
  • Below-cost Medicare payment typically leads to home health agency closurebecause – unlike other sectors – Medicare Advantage and Medicaid pay even less than Medicare and do not offset Medicare losses.

What Action is Needed:

Congress must act now to stop this unsustainable payment cut from taking effect on January 1.Congress should:

  • Postpone implementation of the rate change to no earlier than January 1, 2015
  • Require a re-evaluation of the CMS methodology for rate rebasing taking into consideration all factors relevant to maintaining access to care
  • Require a report to Congress on the re-evaluation and any needs for a revised rate rebasing methodology by June 30, 2014.

To read the proposed amendment postponing CMS’ rebasing rule, please click here.




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