Skip to Main Content
National Association for Home Care & Hospice
Twitter Facebook Pintrest


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 Health Up, Skilled Nursing Facility Down in Updated CMS 2018 Projections

May 18, 2017 03:29 PM

The Centers for Medicare and Medicaid Services (CMS) expects a continued shift from institutional health care, such as skilled nursing facilities and inpatient hospitalization, to outpatient care, according to the Medicare Advantage (MA) Final Call Letter for 2018.

The MA Final Call Letter provides data on the projected Medicare spending and the new update is based on CMS’ most recent spending and utilization data. The shift away from institutionalization spending and toward outpatient care spending means a dip in Medicare Part A utilization and an increase in Medicare Part B utilization.

The drop in skilled nursing care spending for 2018 is particularly noticeable, with the CMS currently projecting a 10.6 percent decrease, from a per capita $594.31 previously down to $531.30. That 10.6 percent decline was the biggest among all service types for both Medicare Part A and Part B.

However, projected home health Part A spending is now projected to increase from per capital $128.29 to $131.65, a jump of 2.62 percent. This increase is very possibly due to a substitution of home health services at the expense of skilled nursing facility spending.

The decline in projected skilled nursing facility spending is probably due, in part, to increased use of long-term services and supports programs (LTSS). Medicaid is trying to move beneficiaries away from institutions and into their own communities. Consequently, there are fewer patients who live in nursing homes going to the hospital and then back to the nursing home, where they receive skilled nursing facility care payments from Medicare.

In addition, Accountable Care Organizations try to avoid the expense associated with skilled nursing facility care for their beneficiaries, instead preferring a move away from inpatient care to outpatient care.

There has been a gradual, but sustained drop in nursing home residents of about two percent per year, a trend NAHC applauds, as we know the vast majority of people prefer to age in place, in their own homes and communities.

The new CMS projections for Medicare Part B also include substantial spending reductions for durable medical equipment of 10.14 percent and carrier lab of 9.85 percent. Outpatient hospital spending is projected to increase 3.30 percent for Medicare Part B, while inpatient hospital spending for Medicare Part A is projected to drop 3.15 percent.

Home health agency spending under Medicare Part B is projected to remain basically unchanged.




©  National Association for Home Care & Hospice. All Rights Reserved.