The Potential Effects of the New Administration on Home Health Health Policies

Well, the Republicans are back in the White House. This change in political party will bring with it many modifications to policies or even the deletion of certain ones. During the campaign both political parties specifically mentioned home healthcare. How could they not address it with 10,000 Baby Boomers turning 65 every day for almost the next twenty years. Many of these Boomers, even those with medical conditions, want to live in their homes as long as possible, making home healthcare a particularly important issue.

In this blog, we are going to address a few of the polices that have been brought to the forefront already by the incoming administration.

  • Pre-claim Review (PCR) Demonstration was implemented by CMS (Centers for Medicaid and Medicare) to combat high incidences of fraud and improper payments. The roll-out began with Illinois in August and the plan was to implement PCR demonstration in Florida, Texas, Michigan and Massachusetts next. However, the very rocky start in Illinois has delayed the roll-out of PCR demonstration in any other states yet.

In late September, the Partnership for Quality Home Healthcare asked Congress to pass the PUSH (Pre-Claim Undermines Seniors’ Health) Act of 2016. This bill would delay PCR demonstration by one year. Currently, there are 13 Republicans and two Democrats co-sponsoring the bill. Furthermore, Rep. Tom Price, M.D. (R-GA) was the bill’s original sponsor. At the end of November President-elect Trump named Price as the nominee for Secretary of Health and Human Services (HHS). If Rep. Price is confirmed to lead this department, he would have the authority to end PCR demonstration even without Congressional support. The future of PCR demonstration seems very precarious at this point even though it has improved in Illinois.

  • Value-Based Purchasing (VBP) final rule for the Home Health Value-Based Purchasing (HHVBP) model was published by CMS a little over a year ago. The goal of this model is to ensure more efficient and higher quality care to Medicare patients. It is designed to leverage the successes and lessons learned from other VBP programs. President-elect Trump stated that he plans to modernize Medicare, and we believe VBP will be one of the ways to accomplish this goal. VBP and bundled care/payments will be the new norm moving forward.
  • Copayments were abolished over 40 years ago in 1972, but as we mentioned in a previous blog there has been a recent proposal in Washington to re-institute them for home healthcare services. The combining of Medicare Part A and Part B will lead to a single framework for beneficiary cost sharing, which most likely will result in home healthcare and/or hospice patients being subjected to a deductible and co-payments. This almost certainly will be another component of President-elect Trump’s effort to modernize Medicare.

These are just a few of the policies that may be affected by the incoming administration. In the coming months, there will be many more that will be brought to the forefront. These policies and others will be addressed in our upcoming webinars and conference presentations. If you are interested in staying up-to-date on the latest home healthcare/hospice changes, please visit our webinars and events pages for further details on our future sessions.

“Advocates ‘Turn Up the Volume’ on Effort to Delay Pre-Claim”, Tim Mullaney, November 30, 2016, Home Health Care News
“Election Impact on Home Care & Hospice – Medicare”, November 16, 2016, NAHC

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