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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

Proposed Medicare Home Health Payment Rule: Impact on Rural Providers

August 5, 2014 03:24 PM

The proposed rule regarding home health prospective payment for 2015 issued by CMS on July 2, 2014 will have a unique impact on some rural providers. The cause of the impact centers on the rate adjustment that is made to reflect differences in wages among geographic areas and the application of a 3% rural add-on to the payments when the patient resides in an area designated as rural.

If finalized, CMS will apply a wage index adjustment that uses a 50/50 blend of 2014 and 2015 geographic area designations, otherwise known a Core Based Statistical Areas (CBSA). The reason for the blend is to provide a smoother transition to the new CBSAs that were approved in 2013 by the Office of Management and Budget (OMB) that are based on 2010 census data. In the 2006 Medicare payment rates, CMS also used a 50/50 transitional blend when OMB devised the CBSAs to replace the previous Metropolitan Statistical Areas (MSAs).

The switch to the new CBSAs means that 105 counties currently designated as rural would change to urban status. In addition, 37 urban counties would change to rural status. That means that HHAs serving the formerly rural counties will lose the 3% rural add-on with episodes that end January 1, 2015 and later. CMS confirmed that it intends to apply the rural add-on based on the 2015 CBSA designation even though it will use a 50/50 blend of 2014 and 2015 wage indexes.

The affected counties are set out in TABLE 13 and TABLE 14 in the Notice of Proposed Rulemaking can be found here

 While not wholly related to this change, CMS estimates that rural home health agencies will experience a greater reduction in 2015 payments (-0.5%) than urban agencies (0.2%) in comparison to 2014. That is a strong indication that the rural add-on loss in 105 counties is not offset by a comparable gain in the 37 newly rural counties.

The loss of the rural add-on will occur in various counties located throughout the country. Counties in 37 states will lose the rural add-on while counties in 18 states will gain it. CMS does not directly control the areas designated as rural and urban. However, it does control when it adopts any new OMB approved geographic designations, the use of a blended transition approach to wage index application, and the determination of whether to apply the rural add-on to both years of a transitional period.

NAHC intends to submit formal comments in the rulemaking process advocating for the application of the rural add-on in any county that is designated in the 2014 and 2015 CBSA standards.




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