CMS Official Addresses Outlook on Medicaid Home Care Policy at the March on Washington (Part 1 of 2)
April 14, 2016 11:22 AM
Melissa Harris, Senior Policy Advisor for the Disabled and Elderly Health Programs Group at the Center for Medicaid and CHIP Services, Centers for Medicare and Medicaid Services (CMS), spoke at the National Association for Home Care & Hospice’s (NAHC) 2016 March on Washington Conference regarding the outlook on Medicaid home care policy. In introducing Ms. Harris, William A. Dombi, Vice President for Law at NAHC, said he has found her to “not only be an accessible and intelligent individual working at CMS,” but someone who understands the “real life aspects of Medicaid.” Further, he said the she understands “that people should be given the opportunity to stay home for all of care,” and that Medicaid in recent time has been recognizing the need to rebalance long-term care spending towards home and community-based services.
Ms. Harris said that Medicaid has indeed been “moving really over the last couple decades to more of a focus on home-based care.” While “there will probably always be room in some context for institutions in the Medicaid program,” she said that “by and large the goal of Medicaid is to make sure that people have choices and, if they want to be receiving care in their communities, in their homes, it is there for them to receive.” She added that the home care and hospice community has “the deep appreciation of all of us at CMS” because “you are the ones who are in the trenches every day delivering the services that are really at the root foundation of the Medicaid program.”
She acknowledged “some of the forces that are swirling around the home care industry at this time” due to actions by the federal government. “My commitment to you is that CMS is aware of them. We don’t necessarily have magic bullets to have an easy solution for them but we are very cognizant of all that you are dealing with,” she said.
The success of Medicaid will continue to be dependent on home and community-based care, she said. “It’s going to be through you, and with you, that we continue to be successful - having a real choice for people to maintain themselves in the community and stay out of institutions - and so your role in the success of the program is pivotal and much recognized at the federal level.”
Regarding the “megatrends” in Medicaid home care policy moving forward, she highlighted continued trends toward managed care and value-based purchasing. “It’s not always a quick conversation at CMS as to what direction we are taking in terms of payment policy, payment reform, but we are always interested in new ideas that really hit the three-part aim that is still very much the mantra at CMS, which is, ‘better care, better health experience, lower cost,’” she said. “It’s very hard to argue with those three tenets, and if a state puts in front of us a payment model that can accomplish those three, then it will have a lot of consideration given to it… I think managed care and value-based purchasing are likely here to stay unless some kind of surprise comes upon us.”
With the end of the administration approaching, she said, “most likely I would say that we are coming to the end of a pretty heavy period of regulatory revisions… and as the dust is settling on some of the new regs – some of which are not even effective yet - I think a lot of us are kind of trying to get our bearings under us and find out what all of this means for Medicaid moving forward. And, as usual, you all will be right at the epicenter because, as home care providers, pretty much all of it will be impacting you.”
Stay tuned to NAHC Report for Part II of our coverage on the session with Melissa Harris regarding the outlook on Medicaid home care policy at the March on Washington.