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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

House Members Propose Single Value-Based Purchasing Program for Post-Acute Care Providers

August 19, 2015 08:24 AM

House Ways & Means Health Subcommittee Chairman Kevin Brady (R-TX) and Congressman Ron Kind (D-WI) recently introduced legislation that would establish a value-based purchasing program for all post-acute care (PAC) services. The bill would create an incentive pool for four post-acute settings—home health agencies, skilled nursing facilities, inpatient rehabilitation facilities and long-term care hospitals. All of these PAC providers would compete for bonus payments based on only one quality measurement—Medicare spending per beneficiary. In addition, the bill would repeal the market basket cuts for post-acute providers scheduled for 2018 (see previous NAHC Report article here). It would also sunset the already established VBP program for skilled nursing facilities beginning in fiscal year 2026.

The lawmakers have proposed the single VBP program for post-acute care providers to replace the separate VBP programs put forward by the Centers for Medicare & Medicaid Services (CMS) in recent years, including the Home Health Value Based Purchasing program included in the Home Health Prospective Payment System (HHPPS) proposed rule for 2016. In a July letter to CMS, Brady and Kind stated that the proposed home health VBP pilot “re-enforces the silo-based nature of the Medicare program by applying one set of rules to a particular patient setting without any regard for the incentives or ripple-effects that it may cause in other health care areas.” They argue that a single VBP program for post-acute care providers is a “better approach.”

The incentive pool would be funded by a 3 percent withhold starting in 2019, and the withhold would increase by 1 percent each year until reaching 8 percent after five years. Approximately half of the funds in the incentive pool would be used for bonus payments and half would be for savings. In order to determine bonus payments, the Secretary of Health and Human Services would be required to establish a performance standard for each provider type in order to measure Medicare spending per beneficiary. Each provider would be awarded a point value for both the provider’s individual performance (55 percent of total point value) and the performance of the Hospital Service Area in which the provider is located (45 percent of total point value). The providers would then be ranked based on point value and receive bonus payments accordingly without regard to the previous year’s performance.

The National Association for Home Care & Hospice has taken the position in its Legislative Blueprint for Action that Congress should monitor the progress of the ongoing value-based purchasing demonstrations or proposals and use the findings to guide its consideration of a full-fledged value-based payment system for Medicare home health services. Any legislative action in this area must:

  • Be developed in conjunction with provider stakeholders;
  • Be tested as a pilot program prior to full-fledged implementation;
  • Be fair in its assessment of the quality of care provided to home health patients and incorporate pending OASIS changes, as well as a mix of process and outcome measures;
  • Refrain from negatively affecting patient access to care;
  • Be consistent with the home health PPS and appropriately risk-adjusted;
  • Limit  any  expansion  of  data  collection  requirements  and  fully  reimburses agencies for the costs of any additional data collection requirements that are imposed;
  • Only reward agencies for care elements over which they have some control;
  • Reward high scoring agencies as well as those that demonstrate improvement for the dynamic value of home health services to the entire Medicare program;
  • Not pose cash flow difficulties for agencies, with the incentive pool not to exceed 2 percent of home health payments; and
  • Allow the Secretary of Health & Human Services sufficient discretion to delay application of P4P if implementation concerns arise.

Click here for a fact sheet on the legislation and here for a section-by-section analysis. 




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