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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

Heath 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

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

MedPAC Expected to Again Recommend Home Health Payment Rate Freeze, Copays and Accelerated Rebasing: New Recommendation on Rehospitalization Penalties

January 4, 2014 09:02 AM

The Medicare Payment Advisory Commission (MedPAC) met recently as part of its annual ritual of developing recommendations to Congress.  This year, MedPAC appears poised to simply restate last year’s recommendations and add a new one focused on penalizing home health agencies with abnormal levels of rehospitalizations.

The recommendations expected to be repeated are a zero inflation update and shifting rebasing from a four year phase-in to a two year phase-in. MedPAC staff expressed that home health agencies maintained a 14.6 percent margin in 2012 and that the current rate rebasing is “too modest” and should be deepened. MedPAC staff forecast that home health agencies will be able to offset most of the rate cuts through cost reductions leading to continued “overpayments” from Medicare.  
NAHC does not agree with MedPAC’s assessment of the impact of rebasing nor the ability of home health agencies to sufficiently control cost growth to maintain current Medicare margins. Data demonstrates that margins are declining while care costs are increasing.

MedPAC commissioners also raised concerns with the growth in patients initiating home care without a prior hospitalization. For some unexplained reason, the commissioners think that avoiding the high cost of a hospitalization through prudent use of home health services is a bad thing. In the past, MedPAC has had a misunderstanding of the home health benefit, believing that it is intended to fit only as a post-acute care service. In reality, Congress had the wisdom back in 1965 to include a home health benefit under Medicare Part A and Part B with the latter allowing for extended coverage without a prior hospitalization requirement.

For the first time, the commissioners were presented with a “Chairman’s Recommendation” that would establish a financial penalty for home health agencies that have too many patient rehospitalizations.

That recommendation is embryonic at this point with details intentionally lacking. The commissioners expressed general support for pursuing the concept in the recommendation while advising staff to look at all variations on the theme including a combination of payment bonuses to reward high performance along with penalties for substandard performance. MedPAC staff and the commissioners recognized the need for a reliable risk adjuster to fairly apply any performance-based payment adjuster.

NAHC has previously supported a performance-based payment reform in home health services with rehospitalizations rates as one of the metrics applied. Most recently, NAHC advanced this concept in recommendations to the Senate Finance Committee which had request input on post-acute payment reform options.

MedPAC will meet again in January to further debate the draft recommendations and vote on final ones. A report to Congress will then be prepared and submitted in March, 2014. For a transcript of the MedPAC meeting, please  HYPERLINK " MedPAC.pdf." click here.




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