Late-January 2019
From the Executive Director
Last week, the Administration released a proposed budget for consideration by the legislature. While we are still analyzing the documents, the proposed budget does not appear to include a Medicaid increase for home health services or the Choices for Care long term care waiver program. 

Over the coming months, we will advocate strongly in the State House for the final version of the budget to invest in these programs that serve some of Vermont’s most vulnerable citizens. We successfully advocated for a 2 percent increase to the programs in each of the last two legislative sessions. These modest increases were not enough, however, to offset the effects of a decade during which these programs saw no rate increases, especially since over the same period, federal home health payments were cut substantially. 
Federal Update
Home health agencies all over the country are preparing for the implementation of a new payment model on January 1, 2020 known as the Patient-driven Groupings Model (PDGM). The new model represents the largest overhaul to the Medicare home health payment system in decades. While an analysis conducted by federal regulators suggests that the change will be neutral or good for Vermont agencies, that benefit will be offset by the loss of a special federal payment known as the rural add-on, which is being phased out over the next several years. Adding to that concern was a report from the Medicare Payment Advisory Commission, a nonpartisan legislative branch agency that provides Congress with analysis and policy advice on the Medicare program. On Friday, January 17th, the commissioner recommended an alarming 2 percent reduction to hospice rates and a 5 percent cut for home health. We will work closely with our federal advocacy partners at the National Association for Home Care and Hospice (NAHC) and our Congressional delegation to fight for older Vermonters. 
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