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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

NAHC, other Post-Acute Care Organizations, Express Concerns on House Proposal to Establish Single Value-Based Purchasing Program

Letter offers recommendations and modifications to make the proposed legislation acceptable to post-acute care community
October 16, 2015 08:53 AM

On Tuesday, October 6, the National Association for Home Care & Hospice (NAHC), along with a coalition of other post-acute care and provider organizations, sent a letter to House Ways & Means Health Subcommittee Chairman Kevin Brady (R-TX) and Congressman Ron Kind (D-WI) regarding legislation the lawmakers introduced earlier this year that would establish a single value-based purchasing program (VBP) for all post-acute care (PAC) services. The legislation is called the Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (H.R. 3298). (For a summary of H.R. 3298, see previous NAHC Report article here). In the letter, NAHC and others expressed concern with the design of the VBP program and that the legislation does not adhere to the implementation timeline that was established under the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014, which has not yet been fully implemented.

The letter explains that the IMPACT Act established a “detailed process through which important data will be collected, analyzed and synthesized,” the result of which “could set the stage for significant future changes to existing post-acute care payment policies.” (For more information about the IMPACT Act, see previous NAHC Report article here). “We believe it is important for the process required under the IMPACT Act to be carried out in accordance with the law’s specified timeline,” NAHC and others stated in the letter. “H.R. 3298 is concerning because it does not adhere to the IMPACT Act’s implementation timeline. We conceptually support value-based purchasing and its application to post-acute care providers, though it should be informed by the data and evidence that is to be produced by the IMPACT Act.”

The letter provided several recommendations to help ensure that the design of a PAC VBP program “truly promotes the goals of tying Medicare payments to value and quality.” Following are the recommendations provided in the letter:

Quality Measures. The measure set in any Medicare quality reporting or payment program should be narrow and include at least one measure focused on patient outcomes such as a functional outcome measure (a key metric to assess success in the post-acute care settings). To the extent that a measure will be used across PAC settings, it should be validated for each setting. Measures should be meaningful to Medicare beneficiaries, and the provider should have the ability to modify its practices to improve its performance on the measure. For the purposes of an efficiency measure, such as Medicare Spending per Beneficiary (MSPB), post-acute care providers should not be held accountable for expenditures that occur during the acute care hospital portion of the episode. Initiation of PAC services should be the trigger of the episode for efficiency measurement purposes.

PAC Provider Performance. Given the differences among the types of PAC providers, the performance of each PAC provider type should be compared only to the same type of provider. Provider performance must take into account issues such as level of direct patient oversight within each setting. Further, each provider type cares for patients with different conditions and goals. It is inappropriate to hold individual providers accountable for performance of an entire hospital service area, and measure(s) and comparisons must be risk adjusted to reflect legitimate differences in patients and settings.

Withhold. The withhold amount in a PAC VBP program should not be more than two percent (2%) at full implementation, which is what is currently in place for the hospital Medicare VBP program and is included in the skilled nursing facility (SNF) VBP program, as well. Currently, all post-acute care providers are subject to various Medicare payment cuts with additional reimbursement dollars at risk under quality reporting programs.

Sunset. Any legislation should be time-limited and include a sunset provision. Moreover, the qualitative and quantitative impact on both Medicare providers and beneficiaries should be evaluated and modified where necessary before any programmatic extension.

NAHC and others further stated that they “remain hopeful that acceptable modifications can be made that could garner post-acute care support across our sectors.” To read the full letter, please click here.




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