NAHC’s Medicaid Action Council to Governors: Support Nurses and Caregivers Who Support Individuals Covered by Medicaid
December 9, 2015 01:02 PM
The Medicaid Action Council (Council), an affiliate of the National Association for Home Care & Hospice (NAHC), has sent a letter to all 50 governors and state Medicaid directors across the country encouraging support for nurses and caregivers who support individuals covered by Medicaid as a means of strengthening Medicaid programs.
In the letter, the Council expressed the importance of nurses and in-home caregivers to state Medicaid programs. “As you know, nurses and other in-home caregivers serve a critical role in keeping individuals and families together and healthy, and are essential assets in your state’s efforts to manage complex clinical and economic conditions in communities,” the Council stated in the letter. “Nurses and in-home caregivers work every day on the front lines of public health, striving to improve or maintain life quality, opportunity and social functioning in complex populations. Without such dedicated caregivers, safety net programs like Medicaid would struggle to meet their mission, and would face more costly alternatives like institutional care.”
The Council further stated that, given the importance of nurses and caregivers to state Medicaid programs, it is important to support policies that support nurses and caregivers. “In recognition of the unique and central role nurses and caregivers play in keeping state Medicaid programs like yours efficient and accessible, the Council welcomes an opportunity to discuss policies and reform principles that our members believe can make Medicaid program still stronger, even more efficient, and more accountable to taxpayers. Nurses and in-home caregivers are squarely in the center of each of our proposals. The Council stands ready to work with you and your designees to design and implement strategies that improve quality and enhance performance in Medicaid home and community based services and Long Term Care Services programs, while honoring the dignity and diligence of the nurses and in-home caregiver professionals responsible for it,” the Council stated.
Following are the policies and reform principles for which the Council expressed support in the letter:
Funding enhancement strategies that can secure a strong economic foundation for nurses and caregivers, recognizing that what our nurses and caregivers create in their work today can yield program savings tomorrow, in the form of hospitalizations prevented, and costly institutional care avoided. Nurses, caregivers and personal care assistants deserve fair and equitable compensation for their efforts which frequently extend to include “first responder” responsibilities, making their contributions even more essential. But because caregiver compensation is often tied to insufficient provider rates set for their services by Medicaid agencies or by managed care organizations, caregivers may take home less than they deserve.
Each affirmative act that a nurse or caregiver takes to keep an individual stable, compliant, healthy, and away from higher cost care centers should be rewarded, with recognition in salary and benefits that reflect the critical contributions that each makes.The Council fundamentally support pay-for-performance systems, and is eager to work with states to structure and implement programs that measure our member’s worth, clinically and economically, to both the consumer and to your state, especially if such systems can provide a pathway to stable compensation and benefits for nurses and caregivers.
Put nurses and caregivers first.The Council is prepared to work with states to design provider payment and delivery reforms that put nurses and caregivers first, and that establish a reasonable compensation structure for home care workers, via changes to provider payment systems and/or pay-for-performance regimes, as long as such change respects the uniqueness of the employment arrangement, where the consumer is the primary focus of responsibility and where the state bears financial responsibility, through itself or through a managed care partner.
The Council said, it stands ready “to join together on behalf of our nurses and caregivers to ensure that their economic foundation today and their future tomorrow is tied to a wage that accurately and fairly reflects the contributions they make every day toward improving lives, managing health, and keeping Medicaid system costs low.”
The full letter from the Council is available here.