I promised myself that I would not get into this mess, but here I am. I went to our monthly staff meeting today and this was one of the topics. I have to share it with you.
One of the things we all have to remember about health care reform is that it is not going to be free. Just putting together the programs and writing the laws and getting the information out will cost millions of dollars.
Well, guess where that money is going to come from? Huge cuts in Medicare B. For reference: Medicare Part A covers hospitalization expenses; Medicare Part B covers outpatient therapy, physician’s office visits, and home health benefits; and Medicare Part D is their prescription medication plan.
As I see it, home health care bridges the gap between inpatient services and outpatient services. Patients who are not considered sick enough to remain in the hospital are sent to a lower level of care: a sub-acute facility, skilled nursing facility, or perhaps home with home health nursing care.
Per Medicare regulations, those patients treated in the home setting must be essentially homebound, which precludes being transported to outpatient facilities. And so, home health nurses, and therapy staff, go to the home to provide interim care and teaching.
Around the year 2000, Medicare implemented their assessment tool: OASIS, which provides answers to very specific questions. Those answers are weighted and determine the skilled need required and thus, the reimbursement that Medicare will make.
In my agency, we have been mandated to follow those Medicare guidelines as strictly as possible. Sometimes the need of the patient requires more visits than Medicare will reimburse, but we have been encouraged to consider that fact, and then make the visits anyway, if they are needed.
If those cuts in Medicare Part B come to fruition, the patients we serve may no longer have access to skilled nursing care. Many of the major health insurance companies look to Medicare: if Medicare won’t reimburse for something, neither will the insurance companies.
Already, one of the Blues has decided that “after care” following hospitalization for major surgery is the sole responsibility of the surgeon. Home health benefits for post-op care in the home health realm have been denied. Patients who would have benefitted from wound assessments by a registered nurse, wound care instructions, and medication management teaching are doing without.
If you think that this is not the appropriate way to finance health care reform, please feel free to go to this website (wecansavehomehealth.org) and sign the petition:
You will be asked to fill in your name, address, phone number and email address. And click on the “I oppose Congress’ proposed Medicare home health cuts” submit button.
The goal is one million signatures. After you submit your petition, the “Virtual Lobbyist” will submit your petition directly to your Congressman.
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