Home care leaders pledge to cooperate on IPS reforms

By MATTHEW HAY and MEREDITH BONNER
HHBR Staff Writers

WASHINGTON – Leaders of the five national home care associations opened the National Policy Conference in Washington last night by pledging to support the unified industry proposal for further reforms to the interim payment system (IPS). Notably, however, National Asso ciation for Home Care (NAHC) Director of Government Relations Dayle Burke acknowledged there will be no further details beyond the six provisions already announced until a Congressional sponsor agrees to introduce the legislation. She added that NAHC’s Bill Dombi and Home Health Services and Staffing Association’s (HHSSA; Washington) Jim Pyles have been drafting legislation in recent weeks.

In addition, Visiting Nurse Associations of America (VNAA; Boston) President Carolyn Markey pledged support of all six principles but emphasized that eliminating the mandatory 15% cut scheduled for Oct. 1, 2000, is by far the most important provision for her organization. Markey said her members simply can not survive a 15% cut on top of the 15 to 20% cut they sustained last year. Privately, the other groups fear that the VNAA may throw its support behind legislation that might emerge that includes this provision but falls short on one or more of the other provisions.

Meanwhile, home care leaders are pointing to data released by the Congressional Budget Office (CBO; Washington) last week that show a dramatic reduction in Medicare home health expenditures. When the Balanced Budget Act of 1997 (BBA) was being debated, CBO predicted a $16.1 billion reduction in expenditures between fiscal years (FY) 1998 and 2002. The CBO now projects a $47 billion reduction over the same period. Based on this, the five groups plan to urge an elimination of the 15% reduction. "We have already far far exceeded the $16.5 billion Congress was looking for," said Markey.

When the BBA was debated, Congress pointed to rapidly growing home health outlays that were expected to reach $127 billion between FY98 and FY2002. In August 1997, CBO revised that number downward to $110.9 billion. The most recent CBO estimate released last month dropped the projected five-year expenditure to $79.1 billion.

NAHC’s Burke said the leaders of all five groups will personally visit key members of Congress as a group in an effort to generate support. In addition, the five groups plan to address a range of policy issues with Health Care Financing Administration’s (HCFA; Baltimore) officials over the next three days. Following the National Policy Conference on Wednesday, the five groups are co-sponsoring a day-long town hall meeting with HCFA representatives on issues ranging from sequential billing to the recoupment of overpayments.