Category: Publications

HCA Report Outlines Fiscal Pressures Facing Home Care, Hospice, MLTC

HCA has issued our 2020 State of the Industry report. Consistent with past reports, we find that the vast majority of community-based providers and Managed Long Term Care (MLTC) plans are operating with negative or negligible margins.

Providers carry an average accounts receivable of 69 days outstanding. Also, about a quarter of direct caregivers leave home care organizations for a variety of reasons, with turnover rates as high as 63 percent, imposing major unreimbursed costs on organizations.

“The fiscal pressures facing New York’s Medicaid budget are rightfully an area of concern that HCA readily shares,” HCA concludes. “However, state policymakers should not overlook other correlative trends impacting home and community-based services,” noting new obligations and responsibilities like minimum wage  changes and the expansion of MLTC benefits for which “state Medicaid funds … have fallen short while nevertheless adding to the state’s budget pressures.” Continue reading “HCA Report Outlines Fiscal Pressures Facing Home Care, Hospice, MLTC”

Use Our Grassroots Advocacy Toolkit

HCA’s grassroots advocacy seeks to enlist you, as an expert in the field and as a constituent, to lobby with local, state, or federal lawmakers on behalf of an issue or cause, with HCA providing guidance, messaging (i.e., what to say or write), and tools for action. To provide you with more information on this process, as well as tips and resources, HCA’s Director of Public Policy and Advocacy Alyssa Lovelace has developed a Grassroots Advocacy Toolkit: Inform, Mobilize and Engage. Continue reading “Use Our Grassroots Advocacy Toolkit”

Home Care: A Major Partner for Tackling Health Disparities

Home care is uniquely positioned as a model to address health care disparities. Disparities are defined as “differences in health outcomes among different groups of people.”

In many instances, home care providers are the main conduit between patients and their physicians and other providers. They offer special care training and assignment, including language and cultural competencies.

What’s more, in-home telehealth interventions are designed to support the clinician’s work addressing disparity-prone conditions such as diabetes, asthma, hypertension, cardiovascular disease, mental health, maternal and child health, HIV/AIDS and others.

Read our publication on Home Care: A Major Partner for Tackling Health Disparities to learn more.

Report Shows Financial, Workforce Struggles of Home & Community Care Sector Amid State Budget Talks

ALBANY — Coinciding with today’s state legislative hearing on the health and Medicaid budget, the Home Care Association of New York State (HCA) today released the findings of our annual financial and trends report for the home and community-based care sector, which serves approximately 500,000 patients and families in New York State.

The report is culled from the latest available state Medicaid financial reports and a survey of providers. It shows: financial margins; revenue and cost cycle and accounts receivable data; workforce turnover and vacancy rates; access issues; and more.

“The data reveals urgent vulnerabilities and needs in the vital in-home safety-net,” said HCA President Al Cardillo in prepared testimony to the Legislature today. (The report is here; HCA’s testimony is here.)

Continue reading “Report Shows Financial, Workforce Struggles of Home & Community Care Sector Amid State Budget Talks”

Home Care Emergency Preparedness Toolkit

HCA and the New York State Association of Health Care Providers (HCP) offer an Emergency Preparedness Toolkit for home care and hospice providers, their patients and families.

This compilation of resources is for agencies to use in assisting patients and families on preparations for any type of emergency situation. The information can be provided to patients and their families at the time of admission so that the planning process is begun and in place as intended – well before an emergency event takes place.

The resources address a variety of issues and considerations necessary for effective preparedness planning. This Toolkit should also assist agencies and patients under the new federal Conditions of Participation for emergency preparedness, which require patient-specific emergency plans.

Slide Presentation: Legislative Forum on Home and Community Care Services

On January 8, HCA, the Hospice and Palliative Care Association of New York State and the New York State Association of Health Care Providers held a forum for state legislators and their staff offering background on home and community care services – in particular, home care, hospice/palliative care and MLTC – that may aid in:

  • Assisting constituents, families and communities with their health care needs.

Continue reading “Slide Presentation: Legislative Forum on Home and Community Care Services”

Document Drop: Co-Sponsor and Pass Bipartisan Bills to Protect Medicare Home Health under PDGM

The U.S. Centers for Medicare and Medicaid Services (CMS) has finalized the biggest change in funding and reimbursement for Medicare home health services in two decades.

Of nationwide concern, this new system is front‐loaded with provider cuts tucked in by unverified CMS predictions about future provider behavior in a system not even yet implemented. Home care in New York State needs your support on bipartisan legislation (H.R. 6932, S.3545 and S.3458) to ensure that this reimbursement overhaul does not jeopardize services for seniors who rely on home care.

Read our white paper to learn more here.

Saluting Veterans in Home Care and Hospice

For Veterans Day, the Home Care Association of New York State (HCA) joins its home care, hospice and managed long term care provider members throughout New York State in recognizing exceptional individuals who have made the ultimate sacrifice through military service.

Our observance of veterans also coincides with National Home Care and Hospice Month in November.

HCA honors the wishes of patients, including our nation’s veterans, to live independently, with dignity, and with the medical,
social or assistive services to help them fulfill those wishes in the community setting.

If you are a veteran – or if your veteran constituents need care – HCA is proud to be a resource for services at (518) 426‐8764.

Document Drop: HCA Seek Fixes to Medicare Payment Reform, NPP Authorizations & Continued NY Exemption from Pre-Claim Review

HCA is seeking technical corrections that would mitigate the financial and service impact of this change for providers and beneficiaries. We also urge a piloting mechanism so that the payment reforms are tested first on a demonstration basis. These and other recommendations are included in a new HCA piece being shared with Congressional offices, titled Vital Corrections, Safeguards Needed in 2018 Home Health Payment Reform Act (see here).

Continue reading “Document Drop: HCA Seek Fixes to Medicare Payment Reform, NPP Authorizations & Continued NY Exemption from Pre-Claim Review”

Home Care, Hospice and Managed Long Term Care Financial and Program Trends 2018

HCA has prepared a 2018 report on the finance and program trends within the home care, hospice and MLTC sectors. This report is based on a statistical analysis of state-required financial documents, a survey of HCA’s membership, and other data sets. It provides aggregate data on financial margins, accounts-receivable balances, direct-care staffing vacancies and turnover rates, and other important findings within New York’s home care, hospice and MLTC sector.


HCA Issues Financial Condition Report, Budget Proposals

HCA has issued its annual financial condition report on New York’s home care and managed care systems, along with a set of vital proposals for consideration in the 2017-18 state budget.

These budget proposals cover the areas of home care and managed care Medicaid payment, regulations, workforce issues, and infrastructure investment.

The financial condition report is available here and the state advocacy agenda is here.

HCA Takes Aim at Federal Regs, Seeks CoP Implementation Delay

HCA this week prepared and circulated two new federal advocacy pieces targeting a series of problematic home care regulations while calling for a one-year delay in implementation of the sweeping new Home Health Conditions of Participation (CoPs).

In a new document, entitled Home Care Advocacy Ask: Regulatory Relief for Home Care Providers, HCA targets five areas of regulation that demand change, consistent with our past advocacy efforts and support garnered from Members of New York’s Congressional Delegation. Continue reading “HCA Takes Aim at Federal Regs, Seeks CoP Implementation Delay”

Briefing Papers: Federal Home Health Policy Summit and Capitol Hill Advocacy Day

The Council of State Home Care Associations is headed to Washington on July 12 and 13 for the first-ever Home Health Policy Summit and Capitol Hill Advocacy Day. The following are a series of briefing papers (in PDF format) about core issues for home care reimbursement, regulatory relief and program needs.

Share this Resource with DSRIP, VBP Leads so They Know Your Value!

HCA has prepared a special resource document that we hope all members find useful in communicating your value-proposition to DSRIP and Value-Based Payment Partners.

We wanted to make sure you saw this piece and find benefit in using it. We also invite you to put your own logo on this piece so that it is branded with your organization’s imprint. (See instructions below.)

The piece is called Don’t Reinvent the Wheel: Home Care is Already Your Hub for Community-based DSRIP and Value Based Dont Reinvent Image 2Services.

Why did HCA create this piece? For several reasons. One, we have heard from many members that Delivery System Reform Incentive Payment (DSRIP) Performing Provider Systems (PPSs) and their committees may not understand home care’s role in the system and the infrastructure you already provide.

What’s more, in some cases, these committees and potential Value Based Payment (VBP) partners appear to be considering options for duplicating home care services from within other settings – in ways that may even interfere with the jurisdictional requirements of Article 36 (an area of concern that HCA is working to address in other venues).

We encourage you to share this document at PPS committee meetings and VBP stakeholder or partnership interactions so that the committees: know more about what home care does; learn some data on home care’s success in meeting PPS and VBP outcomes goals; and understand the regulatory structure that governs home care.

When sharing this document, we also encourage you to present agency-specific data and narratives to support your organization’s successes in achieving the broader points about home care’s value-proposition.

The document can be downloaded in two PDF formats. One format is a four-page document that can be printed and stapled in standard paper size. The other format is designed for 11-by-17-inch printing, front and back, so that it can be produced as a bi-fold. (HCA is happy to assist if you have difficulty printing this piece or need HCA to mail you copies.) Links are below:

Want to co-brand?

Also, HCA is happy to work with you to include your logo on this piece so that it is a co-branded document with your organization’s imprint alongside HCA’s logo.

Please contact HCA’s Communications Director Roger Noyes if you are interested in co-branding with HCA. Just send an e-mail to and we’ll work with you to make this document as effective as possible for your purposes by inserting your logo along with HCA’s.

HCA’s “Priority Asks: Position Home Care to Meet the State’s Policy Goals”

On January 25, 2016, HCA published a two-page document outlining our “asks” of the Legislature for the 2016-17 State Budget and legislative session. The requests, in a document called “Priority Asks: Position Home Care to Meet the State’s Policy Goals,” include the need for reimbursement support and programmatic changes to support home care in a changing state health care policy environment.

Continue 3% Medicare Add-On for Home Health Services in Rural Areas

Congress should permanently extend the 3 percent Medicare rural add-on for home health services delivered in rural areas so that access to skilled home and community based care is not threatened. Congress should also closely monitor the adequacy of the Medicare home health prospective payment system (PPS) payment so that agencies can continue to provide care to Medicare Home Care Association of beneficiaries in rural areas.

HCA’s Financial Condition Report: Home Care Financial and Program Support Vital for Success of New Care-Delivery Models

HCA’s annual financial condition report is a signature publication in our state advocacy efforts. The report combines a rigorous analysis of Medicaid cost reports — which are a financial reporting instrument that home care agencies are required to submit to the state — with a survey of HCA’s members seeking their responses on financial, policy and programmatic trends in home care.

HCA’s Legislative Advocacy Agenda: Driving Health Care Improvement and Savings through Home Care 

Driving Health Care Improvement and Savings through Home Care is HCA’s 2015 State Budget policy statement where we highlight key areas of needed financial, regulatory and programmatic support for the home care system. These policies fall into several main areas:

  • The need for state officials to move promptly on home care-managed care regulatory relief and realignment measures already in the cue as part of the state’s Home Care Regulatory Workgroup process;

Continue reading “HCA’s Legislative Advocacy Agenda: Driving Health Care Improvement and Savings through Home Care “

A Report on the Fiscal Health of Home Care in New York State

HCA’s 2013 financial condition report summarizes the results of a financial analysis of the home care industry coupled with a survey of HCA’s provider members on their cost experiences with payment, regulatory and programmatic changes.