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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

CBO Examines Medicare Per Beneficiary Spending

Growth in Hospice, SNF Use Increase Age Group with Highest Per Beneficiary Spending
December 1, 2015 09:15 AM

The Congressional Budget Office (CBO) has issued a working paper, “Changes in Medicare Spending per Beneficiary by Age” that identifies “rapid growth in spending on SNF [skilled nursing facility] and hospice care and the increasing concentration of the use of hospice care among the very old” as accounting for “almost the entire increase in the age for which Medicare spending per beneficiary was highest.” Between 1999 and 2012, the age with the highest Medicare spending per beneficiary rose by almost a decade, from 87 to 96. Over the same time period, changes in spending on SNF care, hospice care, and acute inpatient care contributed substantially to the changes in the profile of Medicare spending per beneficiary by age. Specifically, spending on SNF and hospice care for all age groups rapidly rose, with an increasing concentration of hospice use among the very old, while use of acute inpatient care declined more rapidly for younger Medicare beneficiaries than for those aged 85 or older. It should be noted that before the late 1990s rapid growth in spending on home health and SNF care were drivers of the average growth rate in spending for very old beneficiaries; that appears to have shifted to a combination of hospice and SNF care in more recent years.

CBO points out that payment rules may have an impact on the quantity of services provided under Medicare, identifying payment for hospice services on a per diem basis (regardless of whether care is provided on that day) as an incentive for hospices to enroll healthier patients with less need for services. CBO notes that the growing percentage of hospice patients that are discharged before death may be a potential indication of inappropriate use of hospice care, but also cites studies positing that the growing use of hospice services may reflect a shift to more cost-effective end-of-life care.

The CBO study found that while growth rates of per-beneficiary spending on hospice care are progressively larger over the period studied (1999 - 2012) for older age groups, this is primarily due to the fact that use of these services is growing more rapidly among older beneficiaries than younger ones. All age groups saw a “striking increase in the annual cost of hospice care, with real spending on hospice care per user rising by more than 50 percent between 1999 and 2012” but “the differences in the increase in spending per user among the age groups were not very pronounced.” CBO identifies differential growth rates in the likelihood of hospice use among the different age groups (with older beneficiaries having a higher likelihood of using hospice) as contributing to the shift in the age profile of Medicare spending.




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