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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

Heath 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 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

Ways & Means Health Subcommittee Explores Value Based Purchasing in Post-Acute Care Settings, Updates Legislation

September 8, 2016 04:24 PM

This week the Ways and Means Health Subcommittee held a hearing on the evolution of quality in Medicare Part A to examine whether existing policies are improving quality and cost-efficiency of care in hospitals and what opportunities there are to improve care delivery in post-acute care settings.  As Ways and Means Committee Chairman Kevin Brady stated, “Physician payment policies are just one piece of the puzzle. To ensure the Medicare program is truly delivering the high-quality care seniors deserve, we also need to improve the way it pays post-acute, or after hospitalization providers.”

This hearing was held immediately following the release of draft changes to the Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (H.R. 3298).  (A summary of the original bill can be found here.)  The legislation would create an incentive pool for four post-acute settings – home health agencies, skilled nursing facilities, inpatient rehabilitation facilities and long-term care hospitals.  When the legislation was first introduced in 2015, NAHC and other post-acute care organizations expressed concerns with the program.  Concerns included that the program does not adhere to the implementation timeline that was established under the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014, quality measures (rather than just a focus on spend) should be narrow and include at least one measure focused on patient outcomes, and the withhold amount in a program should not be more than two percent at full implementation.

Some of the modifications included in the draft changes include adding the functional status measure from the IMPACT Act to take effect in 2020.  The amount at risk is five percent, compared to the 3-8% phase in included in the original bill.  The savings in the bill are funneled to the Medicare Improvement Fund and earmark them to be used for “regulatory relief.”  However, it is expected that this provision will change and the savings will be attributed to a more prescriptive set of provisions providing regulatory relief.  NAHC remains in close contact with the committee regarding the regulatory relief needed within the home health sector.

NAHC will have the opportunity to provide feedback in the coming weeks on the changes made to the legislation.  The changes to the original bill are fairly minor and overall NAHC’s concerns do not appear to be adequately addressed.  The timeline in the updated legislation does not align well with the IMPACT Act, is before validation of quality measures, and is at a level of risk higher than NAHC deems appropriate given that post-acute care providers are subject to various Medicare payment cuts.  NAHC joined other stakeholders in a meeting with Chairman Brady where these general concerns were expressed.

NAHC will be reviewing the changes to the legislation and will continue to express concerns and provide suggestions to the Ways & Means Committee.  NAHC’s position on the details will include the following principles:

  • The IMPACT Act should be fully implemented before any payment reforms are imposed based on the value/quality measures in the Act. 
  • Value based purchasing measures should be focused on a broad set of patient outcomes.
  • Any measures used in value based purchasing should be fully tested for validity and reliability.
  • The amount that value based purchasing puts at risk should be only the level that is sufficient to change provider behavior to focus on quality outcomes.  Putting too much at risk could trigger the closure of providers that lack sufficient resources to improve performance.

A post-acute c are value based purchasing program should be implemented as budget neutral.




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