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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


Predictive Modeling for Bundled Payments

By Danielle Eldredge


Nearly 500 care organizations are enrolled inthe Bundled Payments for Care Improvement (BPCI) initiative. To help navigate uncharted bundled structures, progressive care providers are looking toward predictive modeling.

As defined by the Centers for Medicare and Medicaid Services, BPCI organizations will enter into payment arrangements that include financial and performance accountability for episodes of care. These models may lead to higher quality and more coordinated care at a lower cost to Medicare.

So why would a care provider voluntarily enroll?

The American Medical Association puts it like this: “Bundled payment arrangements are a type of risk-contracting. If the cost of services is less than the bundled payment, participating physicians and other health care providers retain the difference. But if the costs exceed the bundled payment, physicians and other providers are not compensated for the difference.”

In an effort to identify and minimize risk, innovative care providers are turning to predictive modeling technology.

“It’s the evolution of business intelligence,” said Cash Forshee, senior vice president of business development at Medalogix, a company that specializes in post-acute predictive analytics. “Predictive analytics can unveil scientifically driven insight unavailable to clinicians, which increases the opportunity to appropriately adjust care for the patient and reduce costs to the organization.”

Medalogix began as a way to reduce readmissions by helping post-acute providers give their patients better care and meet the requirements of the Affordable Care Act. Medalogix’s analytics combs through a health agency’s historical patient data to learn agency-specific readmission predictors and then identifies the top 20 percent of patients most at risk for readmission.

By understanding just who is at risk, caregivers can adjust care plans and reduce overall hospital readmissions.

This tactic has helped Alternate Solutions Home Care in Ohio reduce 30-day readmissions by 36 percent.

“Reducing readmissions has strengthened our relationships with referring hospitals but, more importantly, has improved our patients’ physical and emotional health,” said Chad Creech, Alternate Solutions’ chief development officer.

After realizing predictive modeling’s positive impact on readmission reduction, other post-acute organizations reached out to Medalogix about the possibility of a custom-bundled payment support model. The custom solution has since been created and deployed.

The bundled payment solution goes a step further than the readmission reduction solution. It considers diagnosis related group (DRG) data and DRG-payment allotments to ensure hospital clinical data and financial repercussions are incorporated in an organization’s risk analysis for patients.

“Using facility-specific data to understand who is most at risk, and then coupling that information with financial reimbursement information, we can help care providers understand where their resources will be best deployed for optimum outcomes,” Forshee said.

Some are concerned that this type of analysis, which is tied to financial reimbursements, could undermine care — influencing organizations to prioritize patients based on their financial risk as opposed to their clinical needs.

“There is an inextricable link between the financial and clinical risks in patients,” said Medalogix’s CEO, Dan Hogan. “Using scientifically driven insight to effectively prioritize care yields greater patient and organizational outcomes, which in turn reduces financial risk in value-based payment models.”

Medalogix is working to further enhance their risk identification service, adding coordinated care functionality to assist several care providers in understanding where a patient will receive optimum care through each phase of their care episode.



About the Author: Danielle Eldredge is a freelance journalist with a focus on the health care industry. Prior to her career in print journalism she was a general assignment local TV news reporter.


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