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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

IMPACT Act’s “Spending per Beneficiary” Measure to include Hospice Payments

July 8, 2016 11:38 AM

Since passage of the Improving Post-Acute Care Transformation Act of 2014 (IMPACT Act), the Centers for Medicare & Medicaid Services (CMS) has been working to develop cross-cutting measures that will be applicable to post-acute care providers (home health agencies, skilled nursing facilities, inpatient rehabilitation facilities, and long term care hospitals).   One set of measures with potential implications for hospice that will be applicable to most PAC providers beginning October 1, 2016, are the Medicare Spending Per Beneficiary -- Post Acute Care (MSPB-PAC) measures.  Home health providers will be subject to the MSPBPAC measure beginning in January 2017.

The MSPB-PAC measures were developed by Acumen LLC with the goal of “support[ing] public reporting of resource use in all four PAC provider settings as well as to provide actionable, transparent information to support PAC providers’ efforts to promote care coordination and improve the efficiency of care provided to their patients.”  When the draft specifications for the MSPB-PACmeasures were published in early 2016, CMS requested comment on a number of issues related to the measures, including the planned inclusion of hospice occurring during a defined post-acute “episode”   time frame as “associated services”.  This means that hospice spending would be included as part of the total resources used during the post-acute care episode because it is believed that these services may be “reflective of and influenced by the serviced rendered by the PAC facility.”

The National Association for Home Care & Hospice (NAHC) and other hospice stakeholders expressed concern about the inclusion of hospice as an “associated service” because hospice is not a post-acute care service, and NAHC believes that hospice care does not serve as an alternative site of care or as the “next stage” in the continuum of care for achieving the goals of acute hospitalization or post-acute care.  Rather, it represents a change in the focus of care and an acknowledgement of the presence of a life-limiting illness.  Under most circumstances hospice would not be part of the planned progression of care following acute hospitalization unless a terminal illness was discovered during the course of inpatient or post-acute care treatment.  NAHC expressed concern that, among other potential negative consequences, inclusion of all hospice spending in the MSPB-PAC could deter or delay appropriate referrals to hospice care.

In response to these expressions of concern, CMS and Acumen have determined that, while they still plan to include hospice as an “associated service” under the MSPB-PAC measure, they now propose to risk adjust so that episodes including hospice care will only be compared against a benchmark reflecting other MSPB-PAC episodes containing hospice services.  Following is the explanation provided by CMS as part of the Medicare and Medicaid Programs; CY 2017 Home Health Prospective Payment System Rate Update; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements; Proposed Ruleon this topic: 

”During the public comment period that ran from January 13 to February 5, 2016…we sought and considered public comment regarding the treatment of hospice services occurring within the MSPB–PAC HH QRP episode window. Given the comments received, we propose to include the Medicare spending for hospice services but risk adjust for them, such that MSPB–PAC HH QRP episodes with hospice are compared to a benchmark reflecting other MSPB–PAC HH QRP episodes with hospice.  We believe that this provides a balance between the measure’s intent of evaluating Medicare spending and ensuring that providers do not have incentives against the appropriate use of hospice services in a patient-centered continuum of care.”




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