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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

Aetna Withdrawal Heightens Concerns for ACA

August 22, 2016 03:17 PM

Aetna’s decision to drastically reduce its participation in the Affordable Care Act’s individual markets in 2017 has shaken public confidence in the Act, putting health care back into the middle of the political scene in an election year and setting the stage for a future battle over improving the law or scrapping it altogether.

Aetna became the third major insurer to cut back its commitment to state marketplaces since April, following on the heels of United HealthCare and Humana. Last April Aetna expressed optimism about the exchanges, but has now reversed course, citing a second quarter pre-tax loss of $200 million due to higher than projected medical costs.

Impatience with losses appears to make legislative and/or regulatory fixes to the ACA inevitable. What that perfecting legislation might look like is unclear at this time, due to fierce partisan disagreement and the uncertainty of a volatile election season. Little or no action is expected before the November general election.

Republicans have long favored a complete repeal of the ACA and replacement of the law with an alternative. Democrats remain staunchly protective of the ACA, with some, emboldened by the campaign of Senator Bernie Sanders [D-VT], calling for a public option or expansion of Medicare to cover the entire country. President Obama has proposed creating public health plans in areas where competition is scarce.

Compromise legislation would require the GOP to abandon its repeal-or-bust stance toward the ACA and Democrats might have to abandon their push for public plans. A victory by Donald Trump in the November election would call into question the existence of the ACA, but a victory by Democrat Hillary Clinton, currently holding a healthy lead in the polls, would increase the odds of a “grand bargain” being struck. Should Clinton prevail in the election, the scale of her victory would also be important. The Republicans currently enjoy a 54-46 advantage in the U.S. Senate, but Las Vegas odds makers now predict the election will flip control to the Democrats. Clinton’s hand with Republicans would be strengthened with her allies in control of the Senate. It is believed the House of Representatives is almost certain to remain under Republican control in 2017.

Republicans would like to see states given more flexibility in designing market-based approaches to make coverage more affordable, with less public spending, in exchange for covering low income people in states without Medicare expansion.

Changes to the employer mandate, never popular with Republicans and almost universally opposed by the home care and hospice community, are also possible. The exchanges need more people to enroll -- particularly healthy people -- but employers are continuing to cover millions of employees, keeping them out of the exchanges. Relieving the employer mandate burden on companies might fulfill a key Republican goal while simultaneously enabling the exchanges to sign up millions of healthy new customers.

Some Democrats have considered the possibility of requiring insurers to offer exchange products as a condition for participating in Medicare Advantage or Medicaid managed care, something insurers oppose.

The home care and hospice industry has paid the costs under the ACA, but so far received few benefits. Today, some 90 percent of Medicare costs relate to the management of chronic disease; yet Medicare is still geared to acute illness, something that Senate Finance Committee Chairman Orrin Hatch (R-UT) and ranking Democrat Ron Wyden (D-OR) are determined to change. This would be very good new to the home care community.

With profit margins tight or non-existent in many of the insurance marketplaces, providing home care instead of far costlier hospitalization remains an obvious way to reduce costs and not only preserve the Affordable Care Act, but spread its benefits to many who continue to be under-served.




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