NAHC Submits Testimony for Ways and Means Subcommittee on Health Hearing on Medicare’s Benefit Design

NAHC Submits Testimony for Ways and Means Subcommittee on Health Hearing on Medicare’s Benefit Design

Issues surrounding proposed changes to Medicare – including whether or not to add more copayments – became the focal point of recent hearing
February 28, 2013 09:54 AM


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

WASHINGTON D.C. (Feb. 28, 2013) – The House Ways and Means Subcommittee on Health held its first hearing of the 113th Congress Tuesday with the hearing focusing on Medicare’s benefit design – and particularly on proposed changes to cost sharing in the program.

The National Association for Home Care & Hospice (NAHC) submitted written testimony that detailed its opposition to proposals to impose home health and hospice copays. As a counter-measure to the increasing calls from some policy makers to shift more of the costs onto Medicare’s beneficiaries, NAHC’s testimony gave the history of copays…“Congress eliminated the home health copayment in 1972 for the very reasons it should not be resurrected now. The home health copayment in the 1960s and 1970s deterred Medicare beneficiaries from accessing home health care and instead created an incentive for more expensive institutional care.  Reinstating the home health copay today would undo the progress made in efforts to reduce unnecessary hospitalizations and nursing home stays.”

The testimony also illustrated how copays can discourage use of necessary and beneficial care – resulting in the deterioration of a patient’s condition and ultimately leading to more intensive and costly care options. NAHC’s efforts helped to educate members of the Subcommittee – many of whom mentioned home care during their questioning of the hearing’s three witnesses.

NAHC’s testimony reiterated home care’s cost benefit to Medicare while the imposition of a copay would have adverse effects and unintended consequences. A recent analysis by Avalere found that a home health copayment could increase Medicare inpatient hospital spending by $6-13 billion over ten years. NAHC pointed out that “…home health and hospice care already have the highest cost-sharing in Medicare.  On a daily basis, millions of spouses, family, friends and community groups contribute the equivalent of billions of dollars worth of care and support to keep their loved ones at home. Further, care in the home means that the Medicare beneficiary provides all the financial support in terms of room and board that are otherwise paid for by Medicare and Medicaid in an institutional setting.” 

Referring to the burden that adding home health copays would impose on seniors, Congressman Bill Pascrell (D-NJ) asked Patricia Neuman of the Kaiser Family Foundation to confirm that Medicare beneficiaries who receive home health services are among the most vulnerable and then stated that, “not only did [home health care] reduce costs for Medicare, but it also reduced costs for beneficiaries.”

In its testimony, NAHC offered proposals to strengthen Medicare program integrity as well as innovative ideas to expand the use of home care and hospice to ensure the delivery of high quality care at less cost to Medicare. NAHC remains committed to working with all members of the Ways and Means Health Subcommittee while opposing any attempts to impose cost-sharing measures that would restrict access to home care and hospice services. NAHC’s testimony will be included as part of the official record, and is also available online here.

To get more information on yesterday’s Ways and Means Subcommittee on Health hearing – including the written testimony of all three witnesses – please 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 to some 12 million Americans each year who are infirm, chronically ill, disabled and dying. To learn more about NAHC, visit