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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

President’s Budget Includes Provisions for Home Health Copays, Additional Payment Cuts for Post-Acute Care Providers

Budget includes other proposals – bundling and value-based payments – impacting home health care
February 5, 2015 10:33 AM

President Obama released his 2016 budget proposal earlier this week, laying out his agenda and legislative priorities for the coming year. Two of the provisions included in President Obama’s FY16 budget are similar to previous proposals that would be of great concern to the home health community. For more on NAHC’s position on these budget proposals, please see NAHC Report, February 3, 2015.

Specifically, President Obama’s budget once again calls for the introduction of a home health copayment - as well as further cuts to post-acute care providers, including home health care.

President Obama’s budget also includes provisions for a bundled payment program for post-acute providers, as well as value-based purchasing for post-acute care providers. The specifics of these four proposals are included below:

Implement Bundled Payment for Post-Acute Care Providers

Beginning in 2020, this proposal would implement bundled payment for post-acute care providers, including long-term care hospitals, inpatient rehabilitation facilities, skilled nursing facilities, and home health providers. Payments would be bundled for at least half of the total payments for post-acute care providers. Rates based on patient characteristics and other factors would be set so as to produce a permanent and total cumulative adjustment of -2.85 percent by 2022. [$9.3 billion in savings over 10 years]

NAHC believes that bundled payments for post acute care should provide an appropriate focus and emphasis on home health. In its most recent Legislative Blueprint for Action, NAHC states that:

“Congress should monitor the bundling pilot program authorized by PPACA to ensure a reasonable and fair opportunity for home health agencies to participate in and/or manage the payment bundle for post acute care. Such an approach would deter unnecessary re-hospitalizations, thus reducing administrative burden and cost, as well as increase the quality and availability of home health care. This approach is comparable to the tried and tested Medicare hospice program where payment is bundled to a community-based hospice program where hospitalization is the exception rather than standard practice.”

Establish Value-Based Purchasing

This proposal would implement a budget neutral, value-based purchasing program for several additional provider types, including skilled nursing facilities, home health agencies, ambulatory surgical centers, hospital outpatient departments, and community mental health centers beginning in 2017. At least two percent of payments must be tied to the quality and efficiency of care in the first two years of implementation, and at least five percent beginning in 2019. [No budget impact.

With regard to value-based purchasing proposals, which are often referred to as “Pay-For-Performance,” NAHC states in its Legislative Blueprint for Action that: “Congress should monitor the progress of the ongoing Pay-For-Performance demonstration and use the findings to guide its consideration of a full-fledged value-based payment system for Medicare home health services.”

Adjust Payment Updates for Certain Post-Acute Care Providers

This proposal reduces market basket updates for inpatient rehabilitation facilities, long-term care hospitals, and home health agencies by 1.1 percentage points in each year 2016 through 2025. This proposal reduces market basket updates for skilled nursing facilities (SNF) under an accelerated schedule, beginning with a -2.5 percent update in FY 2016 tapering down to a -0.97 percent update in FY 2023. [$102.1 billion in savings over 10 years].

NAHC opposes Medicare home health payment cuts, and states in its Legislative Blueprint for Action that, “Congress should reject any proposals to reduce the market basket inflation update or impose additional rate reductions for home health agencies.”

Introduce Home Health Copayments for New Beneficiaries

This proposal would create a co-payment for new Medicare beneficiaries (those who become eligible for Medicare in 2019 and thereafter) of $100 per home health episode, starting in 2019. Consistent with MedPAC recommendations, this co-payment would apply for episodes with five or more visits not preceded by a hospital or inpatient post-acute stay. [$830 million in savings over 10 years].

NAHC opposes the introduction of a home health copayment, stating explicitly in its Legislative Blueprint for Action that: “Congress should oppose any copay proposal for Medicare home health services and prohibit Medicare Advantage plans from charging a home health copay. Reinstating the copay today would directly conflict with the goal of Congress to modernize the Medicare program.”

Establishment of Home Health Surety Bonds

The proposal would increase the required surety bond amount for Medicare home health agencies to an amount that is no less than $50,000 and commensurate with the volume of payments to the agency. [No budget impact]  For more on this issue, please see NAHC Report, December 9, 2014.

The President’s 2016 budget also contains numerous additional health care provisions, which can be reviewed in the HHS Budget at a Glance document, which can be found here

The budget affirms the Administration’s intention to implement and fund the new requirement under the Improving Medicare Post-Acute Care Transformation (IMPACT) Act to survey hospices no less than once every three years, a position that NAHC supports. For more on the IMPACT Act, please see NAHC Report, October 14, 2014.  

The President’s budget also proposes an elimination of the sequester cuts, including the 2 percent Medicare payment cut.  However, the Congressional leadership is unlikely to agree to eliminate the Medicare sequester cut because it would increase the deficit by well over $120 billion.  NAHC Report will provide more coverage and analysis of other provisions in the President’s budget, including a number of Medicaid provisions affecting home and community-based care, in the near future.

While it is unlikely that Congress will give much consideration to the President’s budget this year, the fact that certain provisions targeting home care are again included is cause for concern. Since Congress is struggling to come up with offsets for fixing or repealing the flawed Medicare physician payment formula (SGR), there is the danger that lawmakers could turn to one or more of the President’s Medicare proposals to find savings.

NAHC encourages all of its members to join with their peers and colleagues next month for the March on Washington to continue to fight against misguided proposals such as the reintroduction of a home health copayment or additional payment cuts. Please visit the NAHC Legislative Action Center to take action on this issue.

For more on the March on Washington, please click here.




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