What They’re Saying

• Home care offers better care, more efficiently delivered, stated an editorial in the Bangor (ME) Daily News. But the industry is facing a crisis no thanks to Congress’ response to massive fraud and abuse uncovered through a 1995 federal investigation of home care. The government decided to trim Medicare’s waste, "but the essential result of the reform was to reward excess and to punish frugality," the editorial stated. At the recent Subcommittee on Investigations hearing led by Sen. Susan Collins (R-ME), lawmakers discovered that the Visiting Nurse Service in Saco, ME, has eliminated 120 of its 420 jobs. It has also dropped retirement benefits and plans to close a branch office. Another agency, the Visiting Nurses of Aroostook County, has cut 37 jobs, frozen salaries, and is operating at a loss. And the Visiting Nurse Service in Bangor has laid off 10 people. "Fewer nurses, fewer visits, more ambulance calls, eventually more nursing homes," the editorial stated. "In the name of saving money, Congress has devised a plan that inevitably will cost more while providing worse care. If it’s not yet a crisis, a planned 15% cut in home care scheduled for next year will make it one." The editorial criticized lawmakers who point to a $2.9 billion decrease in Medicare spending on home care last year. "They’d prefer not to talk about the coming increase in acute care costs. They certainly don’t want to talk about the human cost."

• The Home Health Coalition (Alexandria, VA) said it is concerned that a provision for home health consolidated billing inside legislation for the prospective payment system "ignores the inherent complexities of the home health market and separate reimbursement systems." The coalition wants the provision repealed. "If this provision is enacted," the coalition said, "HHAs will be forced into taking on considerable new responsibilities and liabilities, at the same time they are adjusting to the PPS reimbursement system." Consolidated billing, the coalition said, won’t promote access to high quality services.