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National Association for Home Care & Hospice
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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

NQF Issues Preliminary Recommendations for the HHQRP

January 7, 2016 10:08 AM

The National Quality Forum (NQF), Measure Application Partnership (MAP) has issued its preliminary recommendations on the Centers for Medicare & Medicaid Services (CMS) measures under consideration and is seeking input from the public.

The MAP is a multi-stakeholder partnership that guides the Department of Health and Human Services (HHS) on the selection of performance measures for federal health programs. Each year CMS submits to the MAP a list of quality measures under consideration for implementation in the various federal healthcare quality reporting programs. The list submitted this year included six quality measures for the home health quality reporting program (HHQRP).

Several of the measures reviewed by the MAP during this cycle addressed the following Improving Medicare Post-Acute Care Transformation (IMPACT) Act measure domains:

  • Medication reconciliation;
  • Resource use measures, including total estimated Medicare spending per beneficiary (MSPB);
  • Discharge to community; and
  • All-condition risk-adjusted potentially preventable hospital readmissions rates.

One new measure related to fall risk and one new measure for improvement in dyspnea were also included for review for the HHQRP.

Five of the six measures for home health quality reporting received a preliminary recommendation to encourage continued development; one measure did not receive support by the MAP.

The six measures for the HHQRP and the MAP preliminary recommendations with comment highlights are as follows:

Encourage Continued Development

Drug regimen review:

The MAP members had several concerns with this measure. Members noted the challenge of defining some of the measure components, specifically “a clinically significant issue. The members asked for greater clarity on defining the drug regimen review process and greater emphasis of the inclusion of non-prescription medication (including supplements). MAP members also raised some concerns about the feasibility of this measure and noted the need to clarify the roles of the interdisciplinary team.


The MAP members noted the potential for unintended consequences. In particular, the group raised concerns about issues of premature discharges. Members also noted the need to consider risk adjustment for severity and socioeconomic status.

Falls risk composite process measure:

The MAP members noted that this composite measure addresses falls risk and related clinical intervention assessments, which are considered safety measures and meet the goals of the HHQRP.

Potentially Preventable 30-Day Post-Discharge Readmission Measure for Home Health Quality Reporting Program (Required under the IMPACT Act)

The MAP members raised concerns about potential overlap between other readmission measures and that this may introduce multiple penalties for the same readmission. The members asked for greater clarity about the definition of a potentially preventable readmission. Members also raised concerns about this measure for the home health setting, especially as the patient may not be under the care of the home health agency immediately post-discharge.

Discharge to Community-Post Acute Care (PAC) Home Health Quality Reporting Program (Required under the IMPACT Act)

The MAP members noted that available discharge codes and coding practices could cause confusion about the results of this measure and could also introduce validity concerns. The need for greater clarity about the intent of this measure, especially how they may impact patients and consumers was addressed. The MAP members also raised concerns about the multiple ways that readmissions are being measured and noted that a provider could potentially be penalized multiple times for the same occurrence. Further, the MAP members noted concerns about the risk adjustment of this measure, particularly for the home health setting and the need to appropriately risk adjust the measures to avoid unintended consequences

Do Not Encourage Continued Development

Improvement in Dyspnea in Patients with a Primary Diagnosis of Congestive Heart Failure, Chronic Obstructive Pulmonary Disease and/or Asthma

The MAP members disagreed with the denominator approach of focusing on specific populations and encouraged a return to a broader population approach. The members noted that dyspnea is an important quality of life issue to patients across post-acute care settings and should be a focus of improvement for all suffering from the condition.

Many of the concerns expressed by the MAP members are the same concerns the National Association for Home Care & Hospice (NAHC) has regarding several of the proposed measures. NAHC is pleased that the MAP has exercised thoughtful consideration in their deliberations and will continue to follow the measure approval process.

The MAP also reviewed several quality measures for implementation in the hospice quality reporting program that will be addressed in a separate NAHC report article.

To review the recommendations in more detail and to submit comments go here.

Public comments are due January 12, 2016.




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