Home Health Payment Innovation Act of 2018

Mr. President, I rise today to urge my colleagues to support

the Home Health Payment Innovation Act, which I have introduced with Senator Stabenow and Senator Nelson. Our legislation would help preserve access to existing home health services under the Medicare program while also providing a pathway for innovative approaches to utilizing these services moving forward. This bipartisan legislation is endorsed by the National Association of Homecare and Hospice as well as the Partnership for Quality Home Healthcare.

I have been a strong supporter of home care since my very first home visit during my second year of Senate service. This experience gave me the opportunity to meet and visit with home health patients, where I saw first-hand what a difference highly skilled and caring visiting nurses make to the lives of patients and their families. I have been a passionate advocate for home care ever since. Last year, I was delighted to be recognized with the Ruby Slipper award from the Maine Home Care and Hospice Alliance--appropriately named because as Dorothy said in The Wizard of Oz, ``There's no place like home.''

The highly skilled and compassionate care that home health agencies provide in Maine and across the country has helped to keep families together and enabled millions of our most frail and vulnerable individuals to avoid hospitals and nursing homes and stay just where they want to be--in the comfort and security of their own homes. In fact, in 2014, AARP found that nearly 87 percent of of adults over 65 years old want to stay in their current home and community as they age. Furthermore, 85 percent of home health patients live with three or more chronic conditions.

The legislation I am introducing today ensures the viability of home health services now and in the future. First, the Home Health Care Payment Innovation Act provides two key adjustments to the Bipartisan Budget Act of 2018 home health payment reform provisions. These changes would prevent premature payment rate cuts by basing any behavioral adjustment on observed evidence. It also provides a phase-in for any necessary rate increases or decreases to limit the risk of disruption in care. This phase-in is critical for home health providers as CMS has already proposed cutting Medicare payment rates in 2020 by more than $1 billion in the first year alone, based purely on assumptions of changes in behavior.

Second, the legislation provides a pathway to expanded use of home health care in Medicare without increasing program spending by providing flexibility on waiving the ``homebound'' requirement for home health services when a plan or innovative care delivery models such as an ACO determines that providing care in the home would improve patient outcomes and reduce spending on patient care.

By helping patients to avoid more costly hospital visits and nursing homes, we already know that home health saves Medicare, Medicaid and private insurers millions of dollars each year. Moving forward, as plans and providers continue to experiment with innovative ways to deliver care and improve value in Medicare spending, allowing them the flexibility to waive this limitation will help advance the goals of ensuring that care is delivered at the right time, at the right place, and at the right cost. The legislation I introduced today provides the pathway to do just that--promote innovation in home health. I urge my colleagues to support this legislation.

Mr. President, I rise today to urge my colleagues to support

the Home Health Payment Innovation Act, which I have introduced with Senator Stabenow and Senator Nelson. Our legislation would help preserve access to existing home health services under the Medicare program while also providing a pathway for innovative approaches to utilizing these services moving forward. This bipartisan legislation is endorsed by the National Association of Homecare and Hospice as well as the Partnership for Quality Home Healthcare.

I have been a strong supporter of home care since my very first home visit during my second year of Senate service. This experience gave me the opportunity to meet and visit with home health patients, where I saw first-hand what a difference highly skilled and caring visiting nurses make to the lives of patients and their families. I have been a passionate advocate for home care ever since. Last year, I was delighted to be recognized with the Ruby Slipper award from the Maine Home Care and Hospice Alliance--appropriately named because as Dorothy said in The Wizard of Oz, ``There's no place like home.''

The highly skilled and compassionate care that home health agencies provide in Maine and across the country has helped to keep families together and enabled millions of our most frail and vulnerable individuals to avoid hospitals and nursing homes and stay just where they want to be--in the comfort and security of their own homes. In fact, in 2014, AARP found that nearly 87 percent of of adults over 65 years old want to stay in their current home and community as they age. Furthermore, 85 percent of home health patients live with three or more chronic conditions.

The legislation I am introducing today ensures the viability of home health services now and in the future. First, the Home Health Care Payment Innovation Act provides two key adjustments to the Bipartisan Budget Act of 2018 home health payment reform provisions. These changes would prevent premature payment rate cuts by basing any behavioral adjustment on observed evidence. It also provides a phase-in for any necessary rate increases or decreases to limit the risk of disruption in care. This phase-in is critical for home health providers as CMS has already proposed cutting Medicare payment rates in 2020 by more than $1 billion in the first year alone, based purely on assumptions of changes in behavior.

Second, the legislation provides a pathway to expanded use of home health care in Medicare without increasing program spending by providing flexibility on waiving the ``homebound'' requirement for home health services when a plan or innovative care delivery models such as an ACO determines that providing care in the home would improve patient outcomes and reduce spending on patient care.

By helping patients to avoid more costly hospital visits and nursing homes, we already know that home health saves Medicare, Medicaid and private insurers millions of dollars each year. Moving forward, as plans and providers continue to experiment with innovative ways to deliver care and improve value in Medicare spending, allowing them the flexibility to waive this limitation will help advance the goals of ensuring that care is delivered at the right time, at the right place, and at the right cost. The legislation I introduced today provides the pathway to do just that--promote innovation in home health. I urge my colleagues to support this legislation.