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Since Governor and Legislators Agree on Value of Homecare, Advocacy Group Says Time is Now to Make it Available to More Pennsylvanians

HARRISBURG, Pa., April 8, 2008 /PRNewswire/ -- The numbers tell the story, Vicki Hoak, executive director of the Pennsylvania Homecare Association, said quietly to the Senate Aging and Youth Committee today. The Medicaid reimbursement for a year of care in a nursing home is $67,000 per person. For an acute care hospital, the bill could be several times that amount. Reimbursement for homecare is just $21,000.

Since the Governor and legislators agree that homecare is an effective and lower cost alternative to institutional care, Hoak said, the time has come for the Commonwealth to put more funding into homecare to make it available to more citizens.

Part of the Commonwealth's commitment to homecare should come, she said, in the form of increased funding per homecare visit. The state has increased its Medicaid reimbursement for homecare only once in the past 16 years, she said, but that amount ($77 per visit) is about $41 less than the actual average costs incurred per visit by homecare providers.

The state also has been under-spending a special category of funding for homecare known as the "Aging Waiver" by a total of $200 million dollars. As the only Medicaid program that provides in-home care to seniors, this action has cost many Pennsylvanians the convenience and comfort of receiving care in their home, and possibly placed them into a long-term care facility.

Gov. Edward G. Rendell, along with lawmakers have praised homecare as the key to keeping residents of the Commonwealth out of long-term care facilities, that also come with a large price tag to help keep up with overhead costs.

"Next year's proposed budget includes sound initiatives that seek to improve our long-term care system: expanding adult day, studying the rate-setting for the Aging Waiver program and exploring the possibility of adding a personal care benefit to Medicaid and leveling the playing field to allow community spend down," said Vicki Hoak, executive director of the Pennsylvania Homecare Association.

A Carnegie Mellon Study conducted on behalf of Blue Shield of California is an example of how in-home care can help in reducing health care costs. The study examined the importance of "patient-centered management" on about 700 patients with chronic conditions. Each patient received coordinated care from a team of physicians, nurses, homecare, hospice and social workers. The results showed a 38 percent decrease in hospital admissions, a 30 percent decrease in emergency room visits, and a savings of $18,000 per person. But the most significant result was a 22 percent increase in homecare utilization.

The Pennsylvania Homecare Association is seeking a $10 million increase in the state's 2008-09 budget allocation to increase the Medicaid reimbursement to $100 per visit for skilled services. The increase will help offset the cost of nursing and therapeutic care, rising gasoline prices, and workers' compensation premiums for home health agencies.

Medicaid provides basic health care for low-income individuals under the age of 60 and for the elderly under the state's Aging Waiver program. Nearly two million people are covered by Medicaid in Pennsylvania, but only about 10,000 of those receive at-home health care and another 12,000 people under the Aging Waiver, Hoak said.

Hoak applauds the Administration officials who have shown support in shifting care from long-term care facilities to home-care of community-based services. She added that this gives patients the ability to choose how and where they would like to receive their care. But she still sees a disconnect between the intent and the action.

"We know the Rendell Administration believes in home healthcare and the increasing role it should play in the continuum of care. We just wish he would give the instruction clearly to the state's various departments and agencies to 'make it so,'" said Hoak.

The Pennsylvania Homecare Association is headquartered just outside of Harrisburg and represents more than 300 agencies that deliver care and support directly in the homes of more than a million elderly and disabled citizens in the state of Pennsylvania. To learn more about in-home care, visit the PHA website at

SOURCE The Pennsylvania Homecare Association
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