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Home Care Alliance of Massachusetts

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Home Care Alliance Opposes Recommendation of Co-Pays for Patients Cared for at Home

Industry Calls Co-payments an Inappropriate Burden and a Tax on Most Vulnerable Elders.

Boston, MA, March 23, 2011 --( The Home Care Alliance of Massachusetts is joining other state and national organizations in vehement opposition to the Medicare Payment Advisory Committee’s (MEDPAC) recommendation to Congress that would impose a copayment on Medicare home health services.

“It has been shown in many studies that copayments are an inefficient and regressive ‘sick tax’ that falls most heavily on the poorest and oldest Medicare beneficiaries,” said Patricia M. Kelleher, the Executive Director of the Home Care Alliance of Massachusetts.

Congress eliminated home health copayments in 1972 as part of a Medicare modernization effort that concluded that such copayments fell disproportionately on the home health users with the highest Medicare expenses and the worst health status. Moreover, they discouraged using home health in lieu of more expensive nursing facility stays. As recently as 2003, Congress rejected a home care co-pay proposal for the same reasons.

Specifically, MEDPAC is recommending a copayment of $150 per 60-day episode of home health care services. As part of a broader set of reforms in home health payment, this is designed to address what MEDPAC purports as excessive growth in both the number of agencies and percentage of patients using home health services.

“Imposing of a copayment would continue an assault on the Medicare home health benefit that witnessed $39.7 billion in cuts passed by Congress last year,” said Kelleher. “Additionally, on January 1, 2011, Medicare added a new impediment to accessing services by requiring that homebound elderly and disabled patients, as well as hospice patients, will now need to have a ‘face-to-face encounter’ with a physician or nurse practitioner in order to receive home health services under Medicare.”

Most home health users are age 75 or older and in very poor health. A Commonwealth Fund Report recently found that individuals of all incomes with fair or poor health status or age 85 and older spent almost 30 percent of their income already on uncovered medical care, primarily due to Medicare gaps, deductibles and copayments.

“Home health agencies in Massachusetts have supported aggressive efforts to slow growth of home health spending, including testifying in support of a moratorium on new agencies,” said Kelleher. “Asking patients to pay more is not the answer.”

The Home Care Alliance will be holding a briefing in Washington DC on March 29 for legislative staff and meeting with elected officials to oppose this burdensome recommendation and to support positive changes for the industry.

About the Home Care Alliance:
With a mission to unite people and organizations to advance community health through care and services in the home, the Home Care Alliance of Massachusetts is a non-profit trade association and advocacy group providing representation, education, communication, advocacy and – ultimately – a voice for the state’s home health industry. Founded in 1969, the Alliance represents more than 180 home care and home health agencies. For more information, visit

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Home Care Alliance of Massachusetts
James Fuccione

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