Public Policy Priorities

VNAA advocates on behalf of nonprofit home health and hospice providers that offer comprehensive healthcare to Medicare, Medicaid, uninsured and under-insured patients as well as an array of community benefits. While the VNAA agenda is distinctive in terms of the mission and values of its nonprofit, safety net members, it addresses issues that impact all home health and hospice providers. VNAA advocates before Congress, the Centers for Medicare and Medicaid Services (CMS), the Medicare Payment Advisory Commission (MedPAC) and other federal agencies and works in collaboration with other national organizations representing the healthcare continuum.

For more information on recent regulatory activity impacting home-based care providers, please click here.

For more information on recent legislative activity impacting home-based care providers, please click here.

For more information and a printable version of VNAA's 2015 Legislative Priorities (or Congressional "Asks"), please click here.


VNAA Public Policy Priorities

Home Health   Hospice
Medicare Documentation (Face-to-Face): VNAA seeks to minimize regulatory barriers to access and payment by ensuring fair Medicare documentation policies. We specifically advocate for changes in policy to allow home health agencies to provide the certification documentation; ensure fair and uniform implementation of the documentation requirements by the Medicare Administrative Contractors (MACs); and provide financial relief for past denials due to documentation requirements.

Home Health Payment Reform: VNAA advocates for appropriate payment adjustments that recognize the impact of a beneficiary's socioeconomic and socio-demographic characteristics on resource utilization.

Access to Rural Providers: VNAA advocates making permanent the rural payment add-on and identifyingother policies to support access to care in rural areas.
Advanced Care Models: VNAA supports the development of new models of care that provide individuals with serious illness holistic, person-centered palliative care services in conjunction with curative treatments. VNAA advocates for the reimbursement for advanced care planning, palliative care services, and clinician training to deliver those services.

Hospice Payment Reform: VNAA promotes payment models that align resource utilization across a patient's stay and set payment rates based on patient characteristics that cannot be controlled for by the provider.
Cross-Cutting Policy Areas
Value-Based Purchasing: VNAA advocates for the appropriate inclusion of home-based care in new models of care and value-based purchasing arrangements, such as bundled payments, accountable care organizations. 
Quality:  VNAA advocates for the development of quality measures that accurately reflect the work of home health and hospice providers.
Program Integrity: VNAA is working to develop and promote program integrity proposals that target those providers that intentionally game the system while protecting honest and reputable providers.
Health Information Technology, Interoperability & Telehealth: VNAA advocates for full integration of home health and hospice in federal health information technology and health information exchange. We seek federal reimbursement and legislative/regulatory authority to enable home health and hospice providers to share appropriate patient data with other providers in the healthcare continuum including physicians and institutional providers.
Workforce: VNAA seeks to advance legislation and regulations that support home health and hospice providers to recruit and retain a viable workforce including nurses, therapists and other professionals. Additionally, we advocate for policies that expand the authority of nurse practitioners and other appropriate personnel in home health and hospice, including but not limited to signing plans of care, providing face-to-face consultations, and certifying and re-certifying patients.
Medicaid: VNAA advocates for appropriate network adequacy standards and payment rates under Medicaid and provides technical assistance to members seeking to demonstrate their value to states and Medicaid managed care organizations.