NAHC Opposes Proposed Home Health Copays and Inflation Update Cuts in President’s 2016 Budget


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


WASHINGTON, D.C. (February 2, 2015) –The National Association for Home Care & Hospice (NAHC) strongly opposes the Obama Administration’s proposed home health copayments and payment cuts. NAHC maintains that deficit reduction should not come in the form of a “sick tax” on the nation’s poorest, sickest, and most vulnerable individuals.

“Essential home health services are at risk,” said NAHC President Val J. Halamandaris. “Previously enacted changes will cut Medicare spending on home health services by more than $100 billion over ten years — while less than $20 billion is spent each year. As a result of these cuts, Medicare will pay home health agencies less than their costs, meaning that 56 percent of all Medicare home health agencies will be under water by 2017. Congress should therefore reject any additional cuts and any home health copay whether the reason is postponement or elimination of scheduled cuts in physician fees or deficit reduction.”

The President’s budget estimates that a home health copay would reduce Medicare spending by $830 million through 2025. “Studies have demonstrated that the opposite is true,” said Halamandaris. “A home health copay will take Medicare spending in the wrong direction – forcing patients out of high-quality, cost-effective care into much more costly care settings such as hospital, ER and assisted living-based treatment.”

The budget proposal includes a reduction each year in the Market Basket Index (inflation) updates for all post-acute providers from 2016 through 2025, including a 1.1 percentage point reduction for home health care. The proposed update cuts would reduce home health reimbursements by a total of over $15 billion. If they take effect, these payment reductions would be in addition to the rebasing of home health, home health productivity adjustments, and sequestration that lower payment rates by over 14 percent starting in 2015.

“These proposals from the President are essentially repeats from last year’s budget,” Halamandaris pointed out. “Congress refused to enact these suggestions last year and we hope for the same response to this year’s budget. Medicare reforms should never be funded by making indiscriminate across-the-board cuts to home health care or by shifting costs to our most vulnerable citizens through copays.”

The cumulative effect of billions in home health cuts has been to push thousands of providers to the point of bankruptcy — limiting patients’ access to home care and forcing them into costlier care options. Yet the need for home care will only increase as the 78 million baby boomers turn 65 at the rate of 10,000 per day for the next 19 years. Home care is the option that the vast majority of boomers will demand because it helps patients stay independent and keeps families together. Home care is also far more cost-effective for Medicare than institutional options — saving the program tens of billions of dollars every year.

About NAHC
The National Association for Home Care & Hospice (NAHC) is a non-profit organization that represents the nation’s 25,000 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. Along with its advocacy, NAHC provides information to help its members provide the highest quality of care and is committed to excellence in every respect. To learn more about NAHC visit