We are all aware that runaway national health care costs and the need to increase access to care are the main reasons for health reform. Martha’s Vineyard health care providers are certainly feeling the effects of rising costs on a local level. We have read recently in the local papers about how expensive procedures are at Martha’s Vineyard Hospital and how budget stressed the folks at Martha’s Vineyard Community Services are.
However, running below the radar are the national health care reform proposals that would attempt to rein in overall health care costs at the expense of quality home care. The House health care reform bill, Affordable Health Choices Act of 2009, is proposing $56.8 billion in Medicare home health reimbursement cuts over 10 years to help pay for reform. This level of cuts could cripple the Vineyard Nursing Association’s ability to delivery quality home care to all Islanders deserving home care support.
Home health care is already facing a 2.75 per cent reduction in reimbursement for 2010 — a revenue loss of $55,000 for the Vineyard Nursing Association (VNA). In the current health reform bill, Congress would increase the scheduled cut by another 2.71 per cent or $54,200 for the VNA. This would total 5.46 per cent or $109,200 in Medicare reimbursement cuts for the VNA in 2010 alone. Of course a reduction in revenues translates directly to a cut either in the free care we provide or forces us to reduce the number of services we can provide. And the cuts don’t end there. Starting in 2011, home health care agencies could face at least another 5 per cent in reimbursement cuts.
All these cuts fly in the face of studies showing that home health care is not only cost effective compared to institutional care, but is also the consumer-preferred choice. Ask anyone if they would prefer care in the home versus in a nursing home or hospital and they will tell you, without equivocation, that they want to spend as little time in a hospital as possible and want to grow old gracefully in their own home.
The VNA’s ability to keep patients home and families together could get more difficult if Congress passes these cuts, and the reality is that they don’t make a whole lot of sense. Home health care comprises only 4.5 per cent of total projected Medicare payments, and federal government data demonstrates that home health care is significantly more cost-effective than other settings. Home health care has the potential to be a huge cost saver for Medicare by leveraging its ability to care for people in the home, making the proposed cuts to home care very perplexing.
The VNA has grown to become a $3 million agency providing Medicare services, elder care services, services for the disabled, public health services, private care services and soon hospice services. If reining in national health care costs and increasing access to care are two of the main goals for reform, then reducing Medicare home health reimbursement is counterproductive.
Raising more money for the VNA through fund-raising to solve this problem seems like an unfair burden on the community, and a daunting challenge given the current climate. Needing to raise another $100,000 plus on top of the $300,000 we raise today to break even would be a Band Aid solution at best. We need to change the federal government’s approach to cost cutting by reminding them of the critical services the VNA provides and the potential impact of the proposed cuts on the community.
Please consider writing your members of Congress and ask them to support health reform, but not at the expense of the Medicare home health program. You can do this easily by visiting VNAA.org and clicking on “Advocacy” and then “Take Action: Email Congress”. You will be helping yourself, the community and the VNA, a nonprofit organization and the Island’s only home care agency serving the Vineyard for the past 25 years.
Thank you and please help.
Bob Tonti is chief executive officer of the Vineyard Nursing Association. He lives in West Tisbury.