Older Americans More Likely to Support Home Care-Friendly Candidates

The AARP has dubbed the 2008 election as “the 50-plus election,” estimating that voters age 50-plus will turn out in even greater proportions than the 52 percent reported by exit polls during the 2006 elections.

But who are these voters favoring? According to a national telephone survey of 1,000 American adults, Americans age 55 and older are more likely (83 percent) to express support for candidates who support homecare, compared to the 18-to-54 age group (76 percent). Approximately 69 million Americans are 55 or older.

The survey also showed an overwhelming majority (78 percent) of American voters say they would vote for congressional candidates who would strengthen Medicare coverage for power wheelchairs, oxygen devices, hospital beds, and other durable medical equipment and services used in the home.

Is homecare an issue you will consider when casting your vote?

The Biloxi Sun Herald covered this poll; you can read more at http://www.sunherald.com/447/story/330422.html.

Nevada voters concerned with health care and Medicare payments, visit The New York Times.

Poll: Most U.S. adults favor home care http://www.upi.com/NewsTrack/Health/2008/01/29/poll_most_us_adults_favor_home_care/4386/

McCain Advocates for Home Healthcare

At the Republican ABC-Facebook debates which took place early in January, in Manchester, NH, McCain advocated for home healthcare.



“We need incentives for home healthcare as opposed to long term care. In my state of Arizona we adopted a proposal which incentivizes health care providers to keep people in home health care settings. It’s dramatically less expensive than long term care. In Arizona we have one half the numbers of people per capita in long term care facilities as the state of Pennsylvania. Incentives to keep cost down…there are no incentives in the system today.”

Visit http://www.youtube.com/watch?v=ANXQ5YU98Qw to see McCain’s full debate answer (5:18 is when McCain begins to speak about homecare).

President Clinton has mentioned the merits of homecare during the campaign while speaking to a group on behalf of his wife, Senator Hillary Clinton. And former presidential candidate, Bill Richardson, announced at an AARP forum in September that homecare was a centerpiece of his healthcare plan. "Senior citizens want to be able to live out their lives in dignity and in their own homes," Governor Richardson said when explaining his “Independence at Home” plan.

Homecare is becoming a talking point for presidential candidates but voters must keep it at the top of campaign discussions.

Capitol Hill Committee Staff Confirm DME Items Are Top Targets for Cuts

Oxygen therapy and other durable medical equipment items and services are at the top of the list for Medicare reimbursement cuts this year. Politically, it would be easier for Congress to cut oxygen than home health payment rates or skilled nursing facilities, suggested a top aide to the Senate Finance Committee. During a conference last Wednesday, the staffer said oxygen is a key area for Medicare cuts that would likely take the form of a reduction in payment rates rather than a shorter rental period. The staffer asserted that beneficiary co-payments can amount to more than twice the cost of the actual oxygen equipment under Medicare.

The statement was confirmed by a second key staff member for a Ways and Means committee member. They agreed that the payment reduction rate for oxygen would be the preferred approach rather than a shorter rental period.

Now is the time to ramp-up efforts to encourage members of Congress to cosponsor the Tanner-Hobson (H.R. 1845), Hatch-Conrad (S. 1428), and other bills related to the homecare industry.

U.S. Rep Altmire Visits DME Provider in PA

A discussion on competitive bidding’s affect on small businesses took place last week after Representative Altmire visited Blackburn’s, a DME provider in Tarentum, Pa. The Pittsburgh Post-Gazette picked up the story and discussed the impact of round one of competitive bidding on Pennsylvania providers. He spoke with Congressman Jason Altmire (D-Pa.) and Blackburn’s Vice President Georgie Blackburn. The story begins, “Medicare’s plan to cut costs has some small medical suppliers here and nationwide worried that they’ll be locked out of a market that historically has provided a third or more of their business.” The story and visit come on the heels of CMSs’ announcement of the 70 MSAs for the second round of bidding. All providers should take this cue and invite their Member of Congress to tour an HME company.

See full text of the Pittsburgh Post-Gazette story at: http://www.post-gazette.com/pg/08011/848326-28.stm. (Photo of Congressman Altmire and Georgie Blackburn during the Representatives visit)

Durable Medical Equipment Is Slowest-Growing Sector of Medicare and the Most Cost-Effective

Figures released this week show that durable medical equipment is the slowest growing sector of Medicare, increasing 3.8 percent between 2005 and 2006 (from $6.7 billion to$6.9 billion). Total Medicare spending increased 18.7 percent over the same period. In other words, skyrocketing spending may be a problem in Medicare generally -- but not in the DME sector. Home medical equipment is cost-effective and preferred by patients. Nationwide, across all payor categories, health care spending increased 6.7 percent to $2.1 trillion, or $7,026 per person in 2006 according to the report released this week.

The source is the National Health Expenditure Accounts (NHEA), which are the official estimates of total health care spending in the United States. See: http://www.cms.hhs.gov/NationalHealthExpendData/02_NationalHealthAccountsHistorical.asp#TopOfPage.

Why has it taken Medicare so long to impose effective measures to prevent fraud?

In a press release distributed to the national media January 8, 2008, the American Association for Homecare stated that it welcomes and supports efforts to crack down on Medicare fraud announced in Los Angeles earlier the same day in another of a series of press conferences held by the Centers for Medicare and Medicaid Services (CMS) on the subject.

Even before the Medicare program initiated new quality standards and accreditation requirements under the Medicare Modernization Act of 2003, the Medicare program was supposed to conduct an unannounced facility site visit before granting a Medicare supplier number to providers of durable medical equipment. The Medicare program also was supposed to conduct an unannounced site visit at least once every three years in order for the supplier to have its supplier number renewed.

A site visit is supposed to be more than just checking to see if the lights are on at the location. An inspector conducting a site visit has a number of requirements that he or she should be looking for such as verifying delivery slips and checking to make sure there is a complaint file. Unfortunately, Medicare does not seem to do this on a regular basis.

The Los Angeles Times printed a piece entitled Feds to enforce tighter restrictions to help prevent Medicare fraud (http://www.latimes.com/news/local/la-me-fraud8jan08,1,5998232.story?ctrack=1&cset=true). The written piece as well as the press conference linked fraud and abuse efforts with accreditation as required by the competitive bidding program.

See the full text of the press release at the Newsroom at www.aahomecare.org.

List of 70 New Medicare Bidding Areas Spurs Efforts to Ensure Fairness and Access

The American Association for Homecare urged its members to ramp-up efforts to encourage members of Congress to cosponsor the Medicare Durable Medical Equipment Access Act of 2007 (H.R. 1845 in the U.S. House of Representatives) and (S. 1428 in the U.S. Senate). With the January 8, 2008 announcement of 70 additional metropolitan statistical areas (MSAs) where round two of the Medicare competitive bidding program will be implemented, providers in many states are reinforcing the fact that this program will reduce access to care for local patients and will harm many of the providers in these 70 areas. Unless Congress enacts the common-sense changes in H.R. 1845 and S. 1428. For the list of 70 new MSAs, see www.aahomecare.org. The list of ZIP Codes for each MSA will be made available at a later date, according to the Centers for Medicare and Medicaid Services (CMS).

The Tanner-Hobson bill (H.R. 1845) currently has 158 cosponsors. The bill makes changes to the competitive bidding structure in order to ensure beneficiaries’ access to durable medical equipment (DME) is maintained, to protect small providers of quality DME items, therapies, and services, and to foster a dynamic marketplace for Medicare-reimbursed DME. A related Senate bill, Hatch-Conrad-Roberts (S. 1428), has 15 cosponsors at this time.

The Arkansas Democrat Gazette and Chattanooga Times Free Press, as well as other newspapers reported on the news of the 70 MSAs with stories that discussed the downside of competitive bidding in terms of access to care and impact on small businesses.