MA association opposes rate of Medicaid increase
The Home & Health Care Association of Massachusetts expressed strong opposition to the Medicaid reimbursement rate proposal put forth by the Massachusetts Division of Health Policy and Finance. The proposal, which would increase rates by 2.1% for the period 1997-1999, was labeled "unacceptable" by association President Ellen Rothberg.
Although the division’s research reveals that the cost of a home health visit has increased at the inflation rate, the industry has not received a rate increase in more than six years. By contrast, the hospital and nursing home industries have received increases in each of these years at or close to the inflation rate. The proposed reimbursement for the home health care industry for 1997 is 2.1%. In addition, the reimbursement would be based on rates that were set in 1994 and calculated with 1990 cost data; data that does not include an inflation adjustment.
"The division’s major argument for continuing to pay below costs is that access to home health care has not been limited or problematic. Patients are still getting necessary home health services," says Rothberg, who is also the executive director of the Malden VNA. "However, the reason an access crisis has not occurred is that 70% of Medicaid home health services are provided by 25 nonprofit visiting nurse associations. These agencies have a community mission to provide care regardless of payment source or amount."
The rate increase presented by the state would force agencies to subsidize their Medicaid patients through private fundraising, often at the expense of the traditional free care the agencies have provided, the association charges. Even though agencies have frozen salaries and cut back benefits, almost every agency that cares for Medicaid patients reported operating losses in 1995 and 1996, the association adds.
"In the past year, Medicaid has finally begun talking seriously about reducing its dependence on nursing home care," said Patricia Kelleher, executive director of the Home & Health Care Association. "With this rate proposal, it is obvious that they are not committed to supporting home health care and a more cost-efficient means of providing professional health care services."
The Home & Health Care Association sponsored a "Preserve the Home Health Benefit Day" at the Statehouse on Monday, Feb. 24, to enlist legislative support for a more equitable increase.
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