HCA/NYAHSA Lethal Doses Report

Download: HCA and NYAHSA's Press Release on our joint home care fiscal conditions report, entitled Lethal Doses

For Immediate Release: November 5, 2009

Contact:

Roger Noyes 518-810-0665; 518-275-6961 (cell)

HCA: Roger L. Noyes (518) 810-0665
NYAHSA: Kris Jensen-Van Heste (518) 449-2707 Ext. 124

HCA/NYAHSA Report Reveals Home Care System Endangered by Massive Reimbursement Cuts, Unfunded Mandates, Restructuring Proposals

Two-thirds of home care agencies shoulder operating losses; toll to worsen under Governor Paterson's deficit-reduction plan, which would approach one-half billion in home care cuts just since April 2008

The Home Care Association of New York State (HCA) and New York Association of Homes & Services for the Aging (NYAHSA) have released preliminary findings of an alarming statewide report, entitled Lethal Doses, which shows a home care system endangered by a mix of prior-year reimbursement cuts, unprecedented new taxes and provider mandates, and a deficit-reduction plan by Governor Paterson that would bring the total number of Medicaid home care cuts to nearly one-half billion dollars, just since April of 2008.

These findings are "a particularly troubling development when one considers that home care is a cost-effective component of our health care system which allows patients to avoid unnecessary higher-cost service use through interventions appropriately tailored to individual need," the report states. "Health care policy experts know that home care is not only preferred by patients and their families; in-home rehabilitative, preventive, and post-acute services also help patients avoid hospitalization, readmission to the hospital, or premature nursing-home entry, thus saving health care dollars while supporting the desire of patients to remain in a setting that supports their independence and well-being."

Among the report's key findings:

• Two-thirds of home care agencies reported total operating losses across all revenue streams.
• Seventy-five percent of county-operated home care agencies reported operating losses, signaling a stark reality for home care service access in rural areas of the state.
• Fifty-four percent of home care agencies would be "likely" or "very likely" to close under a 10-percent cut.
• Operating losses of Long Term Home Health Care Program (LTHHCP) providers rose by 65 percent between 2004 and 2007. (LTHHCPs serve patients with chronic health conditions and long term care needs.)
• New unfunded mandates and taxes alone are costing home care providers an estimated $64 million — obligations that fall outside of operational expenses devoted to the mission of providing quality care

"Clearly, one-half billion dollars in cuts alone are enough to topple New York's home care system; yet the impact is significantly more lethal when mixed with already inadequate rates of reimbursement and the unprecedented avalanche of staggering new unfunded mandates heaved on providers over the past twelve months," the report adds. "These new mandates have occupied precious staff and financial resources at agencies whose model of care delivery is already streamlined."

HCA/NYAHSA Provider Survey/Cost Report Analysis

The report's findings are derived from: 1) an October 2009 survey of HCA and NYAHSA home care provider members, and 2) a statewide analysis of 2007 home care agency cost reports — the certified financial statements that home care agencies must submit every year to the state as a mechanism for setting policies related to provider reimbursement for services.

It is important to note that though the 2007 cost reports represent the most recent year of data available (current-year Medicaid rates are determined on the basis of two-year-old cost reports), these reports — a snapshot of financial experiences in 2007 — do not reflect the impact of unprecedented Medicaid home care cuts enacted in the last two years, including the nearly $300 million in state and federal share Medicaid cuts adopted between April 2008 and April 2009.

The HCA/NYAHSA membership survey also reflects provider financial and operational experiences as a snapshot in time. Though the survey was conducted just one month ago, in October of 2009, provider responses to the survey do not exactly reflect the impact of cuts levied thus far by the Legislature, since 2009 Medicaid rate reductions are applied retrospectively and have yet to reach provider balance sheets.

The two-page preliminary report, which will soon be followed with a fuller report of more detailed findings, is available here.

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