From a NY Times letter to the editor, written by New York Home Care Association President, Joanne Cunningham.
Home health care has received much attention lately as part of the national health reform debate — and rightly so. These services are a vital component of the health system, caring for the elderly, people with disabilities and the chronically ill, and helping patients avoid higher cost service use, like acute-care emergency room visits, lengthier inpatient stays or premature nursing home admission.
Unfortunately, and ironically, even though home care is a proven cost-saver, federal health reform measures would cut disproportionately from in-home services. At approximately 4 percent of overall Medicare spending, home care is slated for cuts as high as 10 percent under the House and Senate plans.
Mr. Leonhardt claims that home care profits warrant such enormous cuts. Not so in states like New York, where a recent analysis of independently certified financial statements found that an alarming two-thirds of home care agencies are now operating in the red. For the last seven years in a row, these agencies have been losing money treating Medicare beneficiaries because Medicare has underreimbursed home care services.
In many respects, home care is a victim of its own success, self-innovation and responsiveness to health delivery trends. The level and types of services delivered in the home today are increasingly complex. Providers have also witnessed a significantly greater number of patients with intensive health needs; more home care patients today are aged 85 or older, require skilled services, suffer from chronic conditions and exhibit cognitive deficits.
These trends, while having increased our reliance on home care, have also shortened hospital lengths of stay, averted acute-care E.R. visits and allowed people to remain in their own homes — all at a significant savings to health care, and to the benefit of patient health and well-being.