ࡱ> Ej%` bjbjNN [,,((Y-Y-Y-Y-Y-m-u2u2u2u2l24m-X;,!3!3!3!3!3333:::::::$<h>H:Y-73377:Y-Y-!3!3:BK:K:K:7"Y-!3Y-!3:K:7:K:K:Y-Y-0* P,2H8 K:!33 `A8:u27.K:8:;TX;K:4A 884AK:4AY-K:<34rK:5\j5Ov333::A: 333X;7777m-m-m-d0m-m-m-0m-m-m-Y-Y-Y-Y-Y-Y-  Submitted to New York Times 3/24/09 March 24, 2009 Thomas Feyer Letters to the Editor The New York Times 620 Eighth Avenue New York, NY 10018 Dear Mr. Feyer: In the March 23rd editorial (Costly Home Health Care) calling for cuts in Medicare payments for home healthcare, the New York Times paints with the same broad brush used by Washington policymakers eager to score short-term savings without regard to the impact on patients and continuity of care. Without engaging in a worthwhile debate on the correctness of calculations showing supposed extreme profits in home health, an equally important question must be addressed: What will happen to homebound patients if Congress approves these cuts? Patients will lose access to care, particularly if they are disabled, low-income, vulnerable or suffer from multiple chronic conditions. These are the uninsured or under-insured and heavy-care patients typically served by nonprofit Visiting Nurse Agencies (VNAs)...patients whose care is financed in part by the profits imputed to home care. If the mantra of the Administration is to cut with a scalpel, not an axe, then why is it cutting so wildly? Yes, a minority of agencies report egregiously high profits, but more targeted strategies for reining them in are available. Earlier this month, the VNAA, the national association representing nonprofit home health and hospice agencies, released a set of over 20 recommendations to dramatically reduce waste, fraud and abuse in the Medicare home health benefit. Our proposals, if adopted, would likely save taxpayers millions of dollars while saving patients from a dangerous loss of access to critically needed healthcare. Achieving real healthcare reform, with lasting savings, improved access, and superior quality will demand greater precision and creativity than is on display with these proposed cuts. Sincerely, Andy Carter President and CEO Visiting Nurse Associations of America Washington, DC *+;HI .   lmnƹƟƟvƟiƟi_Rh;h?cOJQJ^JhSpOJQJ^Jh;hKmOJQJ^Jh8Th8T6OJQJ^Jh;h`H*OJQJ^Jh;h`OJQJ^Jh;hSpOJQJ^JhhOJQJ^Jhh;OJQJ^Jh8TOJQJ^Jh;OJQJ^Jh?ch5OJQJ^Jh?ch?c5OJQJ^Jh?cOJQJ^J +:;<I % &   abmnz7$8$H$W|||8||||||||||||}۳ۣ{aM3M3hnVCJOJQJ^JaJcHdhdhdh]&'Hh&hnVCJOJQJ^JaJ3hnVCJOJQJ^JaJcHdhdhdh&'Hh&hnVCJOJQJ^JaJ'Hh[&hnVCJOJQJ^JaJjhnV0JOJQJU^J'HhZ&hnVCJOJQJ^JaJ'Hh &hnVCJOJQJ^JaJhnVCJOJQJ^JaJh;hSpOJQJ^Jh?cOJQJ^J50P:p?c/ =!"#$% "s""?"n" Yes, some agencies report egregiously high profits "B"report egregiously high profits"", and their""report""a minority of"z"more targeted strategies for reining them in are available."R" in the Medicare home health f !"#$%&'()*+,-./0123456789:;<=>?@ABCDGgHIJKLMNOPQRSTUVWXYZ[\]^_`abcdehilmnopqrstuvwxyz{|}~Root Entry F0-T8:FData  WordDocument[1Tablek4A benefit. 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"," and improved access"", "0" and superior quality ""iniitial ""proposed"""and heavy-care "D" if Congress approves these cuts""in part ""worthwhile ""typically "", the national association representing nonprofit home health and hospice agencies,"&"President and CEO""Sincerely," "To the editor:""March 23rd " "New York Times""cutting"""Editor in Chief""March "@@@ NormalCJ_HaJmH sH tH DA@D Default Paragraph FontVi@V  Table Normal :V 44 la (k@(No List HH  Balloon TextCJOJQJ^JaJB'B Comment ReferenceCJaJ<@<  Comment TextCJaJ@j@ Comment Subject5\Gz Times New Roman5Symbol3& z Arial5& zaTahoma"Thomas Feyer" "Dear Mr. Feyer"8"(Costly Home Health Care) ""v"">"." 0@P`p  ( 8 H Xhx 0@P`p(8HXh x!""## $$0%%@&&P''d((t))* ++,,,--<..L//\00l11|2334455(66877H88X99h::x;<<== >>0??@@@PAA`BBpCCDEEFF GGO(XX&@@mO(XX&7mO(X&$+$+$$++++mO(XZ&?fmmmO(XZ&G>s>>VV>>sss>mO(XZ& Ssss>>mO([&X>>V>>>>mO(X\&..mO(X\&SYSZSSYYYSmO(X\&)EREJ}EERRREmO(X]&I$mmO(]&!6CCCCCmO(X]&qqrqq%%smO(X]&mO(]&mO(X^&'mO(X^&AmO(^&  mO(X_&IWyWuWWyyyumO(X_&WyymO(X_&qmO(X_&mO(a&K KKK    mO(X{&y  mO(X&RRRRRRmO(X&; RRmO(X&ippmO(X&ZZmO(X& RUR_QRRUUURmO(X&m}m#mm}}}mmO(X&VVVW"WWVVVVmO(X&RSVVVVSSSRmO(X& ppypppmO(X&c>((mO(X&{mmmO(X&"))mO(X&))mO(X&RXRpRRXX XRmO(X&RRRRRmO(X&RRmO(X&RRmO(X&oRUR]RRUUURmO(&TUUUURUUTRmO(X&UUUTRRmO(&RRmO(X&!RRmO(X&RRRaIRRRRRRmO(X&RSSSSSSSSRmO(X&___g____SS__mO(X&ss[sssmO(X&+RVRRRRVVVRmO(&UVVVVRVVURmO(X&QRVVURQQRRmO(X&9RRRRRRmO(X&RRmO(X&RRmO(X&u RRmO(X& RRmO(X&J mO(X& ::mO(X&>W>>mO(X& !>>mO(X&!mO(X&mO(X&(((.l((((ll((mO(X&I!(1((ll((111(mO(&(/111(000(mO(&.   9      mO(X&a!mO(X& U_V_FVVV_FVVmO(X&w!6mO(&!$!# !!$$$$m(XF!77777(XF!mumm66mmuuuum(XFiAAAAggggs (FAU))UUUUل0(F6nnnnnnnnn(XFglnnnnlllln(XF!(XF///0BF////BB//(XF"PPT(XF(XF-"ffffff0(X3F" 3(XF`(XXF#`(XF#(X8F=#$ $$$$(XF!#$$$$$$$$H(X!FY#n|nq&nn||||0(X3F{#(XF(XF#,++++(*XF0000(+*F::::(XF#(XF(XF(Fn/F_____|*N/F#________(FX/F_a__tt__aaaa(FX/F/aaaaaaaaa(F+/FRbbb(FX/F(FX/Fcccccccccc(F/Fcccccccccc(F/Fcccccccccc(F/Fcccccccccc(F/Fcccccccccc(F/Fcccccccccc(F/Fcccccccccc(F/Fcccccccccc(F/Fcccccccccc(F/Fcccccccccc(F/Fcccccccccc(F/Fcccccccccc(F/Fcccccccccc(F/Fcccccccccc(FXEF)(FXFF)o}oooo}}}}jH(FXFF(FXHF)(F.XHFn]A~(FXHF!!(FXIF ..(FXIF&(FXIF)(FXLF(FXLFDDDDDDDDDD(FLFDDDDDDDDDD|*NqLF*d1( FLF(FMF(FXMFBDBBEEBBCCCC,FX`F'**K@****(F-X`F$+++   FMicrosoft Office Word Document MSWordDocWord.Document.89qgenerated automatically by Word. Word requires this version to properly update the shared document.V2HIOh+'0 %` |bjbjNN [,,W?XX $lp4E%t$v$v$v$v$v$v$$;&h($ 6,$P$$BH$H$H$dt$H$t$H$H$H$ `A8:H$t$$TE%H$((H$(HH$,0"H$$$"E% D access to care worthy , report egregiously high profits especially since surgical interventions that spare low-income patients are available? reportsomethey are in the minority, and their.the Medicare Home Health benefit , whixchwpresumably make across the board cuts to nThe time to make across the board cuts to cut home healthcare so broadly is not nownot neverunless there is a clear indication of how cost-effective care will be continued for patients who are homebound. icial, I know the temptation to knowAs a onetimestate budget officialgThe officialstake cutsGreen eyeshade-wearing budgetBudget writers need to consider the full human dimensions of their actions and move far more carefully int, I understand the pressure to achieve savings targets. Although their homebound patients are too sick to march on Washington to protest these reckless cuts, VNAs will''s will be hard work for MedicareIts true that isome of entails hard work, but' DonImplementing our recommendations will be hard, but not nearly as hard as and more first iniitialWe should be worried by this initial misstep. reckless uninsuredto In its editorial calling for cuts in Medicare payments for home health care, the NYT paints with the same broad brush used by Washington policymakers eager to score short- term savings without regard to the impact on patients access to care and continuity of care. Without engaging in a worthy debate on the correctness of calculations showing supposed extreme profits in home hHealth, and reasonable people can disagree on the methods used, an equally important question must be addressed: What will happen to homebound patients if Congress approves these cuts? Patients will lose access to care, particularly if they are uninsured, disabled, low+-income, highly vulnerable or suffer from multiple chronic conditions. These are the uninsured or under-insured and heavy-care patients served by nonprofit Visiting Nurse Agencies (VNAs)...patients whose care is financed in part by the ''profits'' imputed to home care. If the mantra of the Administration is to ''cut with a scalpel, not an axe,'' then why is it swinging an axe so wildly, ?especially since surgical interventions that spare low-income patients are available?  Yes, a minority of agencies report egregiously high profits, but more targeted strategies for reining them in are available. Earlier this month, tThe VNAA last month rreleased a set of over 20 recommendations to the Medicare Home Health benefit for Medicare to dramatically reduce waste, fraud, and abuse, in the Medicare home health benefit. WhixchOur proposals, if adopted, would presumably likely save taxpayers millions of dollars while saving patients from a dangerous loss of access to critically needed healthcare. Achieving real healthcare reform, with lasting savings, improved access, and superior quality will demand greater precision and creativity than is on display with these proposed cuts. The time to make across the board cuts to home healthcare is not nownot neverunless there is a clear indication of how cost-effective care will be continued for patients who are homebound. millions of dollars and reasonable people can disagree on the methods usedealth, ,Chief Executive OfficerAWC rdNYTswinging an axe Editor in Chief New York Times New York, NY Editor in Chief New York Times New York, NY To the editor: In its March 23rd editorial calling for cuts in Medicare payments for home healthcare, the New York Times paints with the same broad brush used by Washington policymakers eager to score short-term savings without regard to the impact on patients and continuity of care. Without engaging in a worthwhile debate on the correctness of calculations showing supposed extreme profits in home health, an equally important question must be addressed: What will happen to homebound patients if Congress approves these cuts? Patients will lose access to care, particularly if they are disabled, low-income, highly vulnerable or suffer from multiple chronic conditions. These are the uninsured or under-insured and heavy-care patients typically served by nonprofit Visiting Nurse Agencies (VNAs)...patients whose care is financed in part by the profits imputed to home care. If the mantra of the Administration is to cut with a scalpel, not an axe, then why is it cutting so wildly? Yes, a minority of agencies report egregiously high profits, but more targeted strategies for reining them in are available. Earlier this month, the VNAA, the national association representing nonprofit home health and hospice agencies, released a set of over 20 recommendations to dramatically reduce waste, fraud and abuse in the Medicare home health benefit. Our proposals, if adopted, would likely save taxpayers millions of dollars while saving patients from a dangerous loss of access to critically needed healthcare. Achieving real healthcare reform, with lasting savings, improved access, and superior quality will demand greater precision and creativity than is on display with these proposed cuts. Sincerely, Andy Carter President and CEO Visiting Nurse Associations of America March Editor in Chief New York Times New York, NY Letters to the Editor The New York Times 620 Eighth Avenue New York, NY 10018 To the editor Costly Home Health Careitsre disabled, low-income, highly v Submitted to New York Times 3/24/09 ?? ?? Do we have this estimate? 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