Here is an article about the 10% cut to Medicare-funded home health services proposed in the health reform bills.
http://www.nytimes.com/2009/12/05/health/policy/05home.html?_r=1&ref=health
The NYtimes has done a "close-up" piece on the effects this would have on a home care agency in eastern Maine that is already in the red, complete with a slideshow of the patients they treat.
Though home health services save a lot of money in the long-term by keeping people at home instead of at nursing homes and hospitals, Democrats have proposed these deep cuts to these services because there is "waste and inefficiency" in the delivery system. They hope that the cuts will encourage home health agencies to make improvements, thus strengthening the program. The Republicans proposed an amendment to stop these cuts, and it was defeated by the Democrats.
I do not think that a sudden 10% cut in payments is a good way to spur innovation and improvement - it seems much more likely that it will simply put home health agencies out of business.
Of course, cuts will have to made from existing government programs to pay for health reform, but it is disappointing to see them come from such beneficial services.
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I agree with you - cutting 10% of their budget seems ridiculous and will inevitably make these small home care organization struggle financially. This is especially surprising in a time when home care should be the paradigm for avoiding the hazards and much higher costs of hospitalization. I'd like to learn more about what Obama means by "waste and inefficiency" in home health care. To broaden this discussion, maybe there is a way to cost-effectively use more e-health and new media tools to help monitor and interact with these patients from afar. Somehow this could maintain their high quality of care at home in a less costly way. It's something to think about.
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