AAHomecare Leadership Conference Examines Future and Likes What It Sees
Taking a break from the day-to-day worries of inherent reasonableness payment reductions and national competitive bidding, the American Association for Homecare (AAHomecare) Leadership Conference, held February 26-28 in St Petersburg, Fla, devoted much of its time to examining broader issues and trends in order to plot a strong strategy for the future.

Countries around the world are struggling with how to pay for rising health care costs, says Leadership Conference keynote speaker Ed Rozynski.

The United States is not alone in struggling with how to pay for health care products and services, international medical technology trade expert Edward Rozynski of Rozynski & Associates, Washington, DC, told the 250-plus members of the Alexandria, Va-based association in attendance during his keynote speech. “This is a debate that is happening all around the world,” he added during a panel later the same day. “But nobody is looking to copy the US managed care system.”

So if managed care—as the current administration proposes—is not the answer to solving the problem of spiraling Medicare and Medicaid costs, is home care? Yes, said Jim Pyles, an industry advocate and partner with the law firm of Powers, Pyles, Sutter & Verville, Washington, DC, during the meeting’s working luncheon. “We have a policy vacuum as far as Medicare and health care reform,” he said. “When I see a policy vacuum, when I see uncertainty on [Capitol] Hill, I see opportunity.”

Legislators are hungry for new ideas, Pyles added, and home care may be their last, best hope for preserving health care in a way patients want because home care can deliver care more cost-effectively than hospitals and institutions can. “The problem is that you are not seen as part of the solution,” he said.

Clockwise from left: “Building Value in Homecare” panelists William Kane of Harvest Partners, New York, and Jeremy Doctrow of Legg Mason Wood Walker Inc, Baltimore, answer questions from Thomas A. Connaughton, president and CEO of the American Association for Homecare, Alexandria, Va, and Les DeFelice, president and CEO of DeFeliceCare Inc, Wheeling, WVa, and chairman of the IT Summit committee.

Instead, home care is often seen as a place where reimbursement cuts can create savings and there are few if any longitudinal studies to show how cuts in home care can actually raise health care costs for the nation, explained Bob Wardell, a former CMS regulator now with the Visiting Nurse Association of America, during the keynote panel. “Help CMS to understand its own data with respect to home care,” he urged.

As the conference moved into its second day, which was devoted to information technology issues, speakers Jeffrey Lewis, president of Lewis Computer Services Inc, Baton Rouge, La, and Albert Prast, chief information officer for Rotech Health Care Inc, Winter Park, Fla, encouraged attendees to think about how information technology could make home care more efficient and consequently an even better solution to the problem of how to control health care costs.

These issues are so important, AAHomecare should consider adding a staff person devoted just to information technology issues, added Gregory Taylor, vice president of business development for Brightree, Duluth, Ga, in his presentation to the members. “They need someone who is thinking about this full time,” he elaborated after the conference. “We as members of the association can assist, but the providers and the association itself, they need some technology leadership.”

With the number of issues straining the resources of AAHomecare at present, adding another person poses a challenge. However, the association was taking the proposal seriously, said Thomas Connaughton, the association’s president and CEO. “I wish we had lots of cash lying around so we could go hire lots of different people,” he said. “But clearly, we have to be a forum to provide and facilitate a thorough discussion and hopefully develop a consensus on an approach to these issues.”

Making home care the solution to rising health care costs through new efficiencies will be a message the association will carry forward.

House Budget Passes Sans Medicare Cuts
Home care industry advocates wiped their brows March 20 as an approximately $200 billion reduction to Medicare over the next decade slipped off the 2004 House budget.

The resolution left Medicare untouched, but the House Budget Committee called for $255 billion in cuts over the next 10 years for a number of benefits, including Medicaid. The Senate Budget Committee proposal, released in March, did not include health care spending reductions. Both supplied an additional $400 billion for a Medicare prescription benefit.

Although the cuts were dropped for now, the Alexandria, Va-based American Association for Homecare (AAHomecare) warned that this would not be the last time the issue would be examined.

“I guarantee that when they are trying to enact a $400 billion drug benefit, they’re going to be looking for savings wherever they can find them,” says Thomas A. Connaughton, president of AAHomecare, noting that the House and Senate may still look to competitive bidding, the market basket increase, the rural add-on extension, or even a co-pay issue for home health for savings

Connaughton praised AAHomecare members for fighting for home health issues and urged them to continue.

Medicare Proposal Lacks Prescription Coverage for All
Comprehensive drug benefits may only be available to elderly Americans if they choose an enhanced version of Medicare, President George W. Bush said in a March 4 speech.

Both Republicans and Democrats criticized the President’s new framework, proposed in the speech, for not offering all Medicare beneficiaries full prescription drug coverage, according to The New York Times.

    “We need a universal drug benefit so seniors who want to stay in traditional Medicare get a prescription drug plan that’s just as good as those who choose a new option,” said Senator Charles E. Grassley (R-Iowa), chairman of the Finance Committee, in the Times article.

In lieu of full coverage, those who choose to stay in the current Medicare system would receive a discount card to reduce the cost of prescription drugs by 10% to 25%.

In addition to the traditional Medicare plan and the enhanced fee-for-service arrangement, Bush’s program would offer seniors a managed care plan.

MedPAC Gives Congress Medicare Suggestions
In March, an independent federal body that advises the US Congress issued budget recommendations that may not sit well with all HME providers.

The Medicare Payment Advisory Commission (MedPAC) report suggested that Congress extend add-on payments for home health services provided to Medicare beneficiaries who live in rural areas at 5% instead of at the 10% payment that expired April 1. MedPAC also suggested Congress eliminate the update to payment rates for home health services for fiscal year 2004.

In a January 22 statement, the American Association for Homecare (AAHomecare) expressed its dismay at the suggestions, released informally at a January 16 MedPAC meeting. AAHomecare President and CEO Thomas A. Connaughton said that, if heeded, the recommendations for cuts in addition to those already implemented by the Balanced Budget Act of 1997 in October, would hit the stability of home health care with a major blow.

HIPAA Privacy Rule Takes Effect
Time is up to prepare for one major component of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The privacy rule, part of a set of standards required under HIPAA’s “administrative simplification” provisions, takes effect April 14. The regulation protects medical records and other personal health information. Under the rule, covered entities must receive specific patient authorization before they can use or disclose protected information in most nonroutine circumstances, and they must provide patients with written notice of their privacy practices and patients’ privacy rights. The rule is available online at www.hhs.gov/ocr/hipaa.

Rehnquist Resigns HHS Position
May 31 will mark the last day on the job for the current Inspector General of the Department of Health and Human Services (HHS), Janet Rehnquist. Her resignation comes amid management reviews by several government agencies.

As inspector general, Rehnquist investigated fraud and waste in Medicare, and she had testified to Congress about fraud in the home health care industry.

Medtrade Hits Vegas in May
Medtrade Spring 2003 is right around the corner! On May 6-8, more than 4,000 home health care professionals will convene at the Las Vegas Convention Center for the event, which is endorsed by the American Association for Homecare, Alexandria, Va. For more information on attending, visit www.medtradespring.com or call the organizers, VNU Expositions, Atlanta, at (800) 933-8735.

Hildebrandt Joins AAHomecare as RATC Executive Director
Sharon Hildebrandt has stepped in to take the place of Mary Lacey Reuther, the executive director of the Re/hab and Assistive Technology Council (RATC) at the American Association for Homecare (AAHomecare), who left the organization to join the US Food and Drug Administration (FDA) as special assistant to FDA Commissioner Mark McClellan, MD, PhD.

“Sharon brings a wealth of legal and technical expertise to her role as RATC executive director,” AAHomecare President and CEO Thomas Connaughton says. “She is an attorney experienced in health care delivery and administration, she is a knowledgeable government relations professional, she has led a nonprofit health care foundation, and she has clinical experience, having served as a physical therapist in general hospital, rehabilitation hospital, and home health agency settings.”

Associated Healthcare Systems Turns 20
Associated Healthcare Systems Inc, Amherst, NY, celebrated its 20th year in the business on February 7, 2003. What began as founder Donald B. White’s dream to help others has flourished into a multimillion-dollar company. When White started Associated Healthcare, he was the only employee and performed the tasks of customer service representative, delivery technician, warehouse manager, purchasing clerk, and CEO. He operated from his garage and served 50 oxygen patients. Today, Associated aids thousands of patients with respiratory home health care.

When asked if he had it to do over, would he? White responds, “Absolutely! I have had fun, excitement, and life-enriching experiences meeting caring and dedicated people throughout the home care industry.”