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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

Summary of MedPAC Report Recommendations for Home Care

NAHC Disputes Projected Medicare Margin for Home Health, Opposes Introduction of Home Health Copay
March 21, 2015 09:13 AM

Last week, the Medicare Payment Advisory Commission (MedPAC) released its 2015 Report to the Congress on Medicare Payment Policy. This article provides a summary of the report’s recommendations for home care. Each year, MedPAC releases a report in March with specific recommendations for Congress on Medicare policy. In making its recommendations, the commission examines a variety of factors that relate to payment adequacy: beneficiary access to care, the capacity and supply of providers, care utilization, quality of care, provider access to capital, and financial margins. The National Association for Home Care & Hospice (NAHC) closely follows MedPAC’s recommendations, as well the reception the recommendations receive in Congress.

As NAHC anticipated in previous reporting, the 2015 MedPAC Report reiterates recommendations from previous years for home care. NAHC has been engaging with MedPAC for months and has expressed concern with its findings as well as opposition to specific recommendations.

MedPAC states that Congress should implement a two-year rebasing during 2016 and eliminate the home care payment update for 2016.  The Commission bases these recommendations on the claim that home health Medicare margins for 2015 are “high.” The Commission projects a margin of 10.3 percent in 2015. According to the report, the projected margin indicates that the base rate is “well in excess of costs” because home health agencies are “providing fewer visits than anticipated.”

“The declining number of visits per episode has contributed to higher agency margins,” the report states. “Overpaying for home health care has negative financial consequences for the federal budget and the beneficiary; implementing the Commission’s prior recommendation for rebasing would better align Medicare’s payments with HHA’s actual costs.”

NAHC disputes MedPAC’s projected Medicare margin for home care as misleading. MedPAC’s calculation covers a range of margins so wide that it fails to capture a realistic margin for the majority of home health agencies. MedPAC’s calculations also fail to take into account the costs of those home health providers affiliated with hospitals, which have the highest costs of all home health agencies. In reality, over 60 percent of home health agencies will face costs that exceed their total payments received by the end of rebasing in 2017.

NAHC also disagrees with MedPAC’s claim regarding declining visits per episode. Many home health agencies have begun substituting technology such as telehealth for in-person visits. However, MedPAC fails to factor telehealth and its costs into its calculations.

It is important to note that, since the annual payment updates are set in statute, eliminating the payment updates for 2016 would require legislative action. For the reasons stated above, NAHC would oppose such legislative action.

The report also reiterates other recommendations from previous years: the home health case-mix model should be revised to rely on patient characteristics; payment levels for therapy services should be based on patient characteristics rather than using the number of therapy visits as a payment factor; a per-episode copayment of $150 should be established for home health care that was not preceded by hospitalization or post-acute care to encourage appropriate use of such services; payments should be reduced for home health agencies with relatively high risk-adjusted rates of hospital readmissions; CMS should identify the types of patients that might best benefit from home health services and develop quality outcome measures for each category.

With regards to the copayment for home health, NAHC will continue to strongly oppose the introduction of any copayment for home health. NAHC recently stated its opposition to a similar proposal in the President’s budget. As NAHC stated in its Legislative Blueprint for Action, the introduction of a home health copayment would be an inefficient “sick tax” on the most vulnerable Americans and would directly conflict with the goal of modernizing Medicare.

NAHC will continue to closely monitor the reception MedPAC’s recommendations receive in Congress.




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