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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

New Analysis: Proposed Government Regulation Will Put More Than Half of America's Medicare Home Health Agencies in the Red

Proposed Cuts Would Seriously Threaten Patient Access to Cost-Effective, Senior-Preferred Home Health Care
September 13, 2011 05:35 PM


For additional information:

Barbara D. Woolley
National Association for Home Care & Hospice
(202) 547-7424

WASHINGTON, DC (Sept. 13, 2011) – In response to changes proposed by the Centers for Medicare and Medicaid Services (CMS) to the home health prospective payment system, the home health community today issued warnings that large adjustments to home health payments will have a significant and alarming impact on the financial viability of America’s home health providers.  According to a new analysis by the National Association for Home Care & Hospice (NAHC), CMS’ proposed policy changes would lead to negative Medicare financial margins for more than half (52.3 percent) of all home health agencies in the U.S. This analysis, based on nearly 7000 financial reports submitted to the Medicare program, was reviewed and validated by the independent health care policy consulting firm, The Moran Company.

The analysis also found that the proposed payment cuts would have a particularly severe impact on rural providers and hospital-based home health agencies.  The analysis found that 65.7 percent of rural providers and nearly 81 percent of hospital-based agencies will see negative Medicare margins if the CMS-proposed rate adjustments are finalized.

“Federal regulators have made assumptions regarding our patient population and patient acuity that do not accurately reflect the reality of home health care in America. As a result, their proposed payment adjustment is dangerously speculative and risks denying Medicare beneficiaries the care they need,” said Andrea Devoti, NAHC board chairwoman. “The Moran Company validation of the analysis underscores our concerns that large payment adjustments will financially cripple providers across the country, therefore creating serious access challenges to vulnerable seniors and threatening needed healthcare jobs – particularly in rural and underserved areas.”

CMS has recently proposed a substantial payment reduction that would decrease the base payment rate for home health services by 5.06 percent for 2012. While CMS contends that the adjustment is warranted on the basis that there has been only limited change in patient acuity in past years, NAHC argues that there is strong evidence showing that patient are sicker than ever and in need of the extensive care that has markedly increased care costs.

The Moran Company analysis states, “We believe the NAHC analysis provides policymakers with a realistic understanding of the potential financial impact of the CMS proposal, if ‘nominal’ case mix growth proves illusory. While ‘nominal’ case mix growth may occur, we cautioned that it might never be possible to determine definitely how much case mix growth is or isn’t real. Consequently, we believe that policymakers may find the NAHC results useful as they seek to understand the impact of the proposed payment adjustments on home health agencies.”

Added Devoti, “With CMS putting money ahead of people rather than looking at the operation of the program, the financial stability of home health providers across the country is at serious risk. As a result, we urge the Administration and Congress to take a close look at this analysis and consider how CMS’ proposed payment policies will impact seniors and disabled persons nationwide. Lawmakers are looking for ways to create jobs and establish financial growth – advancing policies that jeopardize the viability of home health care is not the direction that should be taken.”

Home health care has become increasingly important to millions of American seniors who depend upon it for skilled post-acute care. Approximately 3.5 million Medicare beneficiaries annually receive home health care to recuperate from serious injury or illness at home – at a significant cost savings when compared to other care settings.

In interpreting these margin trends, NAHC used 2009 CMS data, which was the latest based year with a reasonably complete set of cost reports for completing an analysis.   To access the full analysis including potential state specific impact data if regulations were to be enacted, click here.

About NAHC

The National Association for Home Care & Hospice (NAHC) is a nonprofit organization that represents the nation’s 33,000 home care and hospice organizations. NAHC also advocates for the more than two million nurses, therapists, aides and other caregivers employed by such organizations to provide in-home services each year to some 10 million Americans who are infirm, chronically ill, disabled and dying. Along with its advocacy, NAHC is committed to excellence in every respect and provides information to help its members maintain the highest quality of care. To learn more about NAHC, visit




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