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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

Home Care Issues Front and Center at House Ways and Means hearing

September 8, 2016 03:01 PM
Watch the Video: Rep. Tom Price discusses NAHC priorities during House Ways & Means subcommittee hearing.

A September 7th House Ways and Means Health subcommittee hearingon the evolution of quality in Medicare Part A featured an interesting series of questions and answers between Rep. Tom Price (R-GA-6) and Steve Guenthner, President of Almost Family, a home health care company with over 250 locations in 15 states. Price specifically mentioned three issues important to NAHC and its members, pre-claim review (PCR), the physician face-to-face encounter rule and withholding amounts in the value-based purchasing model.

Rep. Price opened his comments by drawing attention to the May 25, 2016 letter, signed by 116 bipartisan members of Congress, calling for the withdrawalof the proposed use of prior authorization for all home health claims in five targeted states.

“At one point, Medicare officials recommended that home health agencies fax in documents, as the electronic system was not working,” said Price. “Home health providers are experiencing submission issues that require more than 45 minutes for each and every pre-claim review request. Pre-claim rejection rates of between 70 and 80 percent.” Price noted the proliferation of complaints about confusion created by burdensome paperwork requirements.

“Would we be aided by a delay in this demonstration so CMS can get their act together?” Price asked Guenthner.

“Yes, sir, I believe we would,” replied Guenthner. “This PCR, or pre-claim review, topic is a direct result of the physician face-to-face requirement that included a subjective narrative that the home care industry, Almost Family included, commented to CMS would likely result in very high audit error rates because the auditor – 18 months to two years after the fact – would subjectively review the narrative written by the physician solely on the basis of the face-to-face document, not on the bases of the entire medical record.”

Price asked what could be done to improve the face-to-face regulation, prompting this calm, but firm reply from Guenthner.

“We would like to see it much more prescriptive, we would like to see it much easier for physicians to execute and what we have here is a trust problem. When the physician certifies the need for home care, they’ve certified that they’ve seen the patient. The only reason to have them write a narrative that could be challenged later is because we don’t trust the physician’s certification.”

Congressman Price then moved to the Medicare appeals backlog, noting that some claims “have been going on for four, five years, in spite of the 90-day requirement under the statute.” Price asked if the home health community would benefit from a global appeals settlement, similar to the ones used for hospitals, prompting a swift affirmative reply from Guenthner. “Yes, sir. Emphatically so.”

Finally, Congressman Price addressed withholding in value-based purchasing, noting that the withhold percent for hospitals was one percent growing to two percent of a number of years. The proposal for post-acute care, however, is a three percent to eight percent withhold, which Price found questionable.

“When I speak to the folks trying to help patients back home and providing the care in the home health arena, they tell me that in many cases their margin isn’t eight percent,” said Price, who went on to wonder if it would be more appropriate to have a withhold amount equivalent to the hospital community.

“Yes, sir,” affirmed Guenthner. “We do think parity is important across provider groups and that the amount at risk should not get out in front of the infrastructure and the information available necessary for providers to execute. If we get too much at risk we have, we have too high a risk of an adverse outcome or an unanticipated event.”

NAHC has worked extensively with Congressman Price’s office on these issues and will continue advocating for much needed regulatory relief and changes to the value-based purchasing legislation. (More information here)




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