VA Eliminates Copayment for Veterans Receiving Home Health Care Services

The U.S. Department of Veterans Affairs issued a final rule eliminating copayments for tele-health services for veterans receiving skilled home healthcare through the agency’s Home Based Primary Care program, in a move lauded by The Partnership for Quality Home Healthcare. 

Eliminating copayments removes a barrier to both veterans and their dependents’ use of clinically- and cost-effective home healthcare. 

The VA continues to lead the way in advancing patient-centered healthcare policies that are improving patient care and reducing healthcare spending without shifting the cost to Veterans,” said Chairman Billy Tauzin, senior counsel to the Partnership for Quality Home Healthcare. “The VA’s Home Based Primary Care program merits close consideration by lawmakers as a model for future Medicare reforms.”

Mandating copayments on home health services often results in a variety of unintended consequences, such as cost shifting and increased healthcare costs resulting from greater use of inpatient care services, research shows. Sometimes, beneficiaries who are required to make a copayment for home health services may forego needed care and consequently see their health worsen, requiring more expensive treatment in an institutional setting. 

The VA’s HBPC program focuses on seniors with complex, chronic disabling conditions at high risk for hospitalization readmission or nursing home placement, and by providing in-home healthcare services, veterans and their dependents can receive the care they need without having to enter a more expensive institutional setting. 

The program has reduced inpatient hospital days by 62%, long-term care days by 88%, and hospital readmissions by 21%, according to VA documentation—”unprecedented outcomes” according to The Partnership for Quality Home Healthcare. This has resulted in a 24% decrease in total healthcare costs for HBPC participants. 

“We have an opportunity to achieve similar outcomes by advancing Medicare policies that mirror the VA’s successful approach, which has proven clinically effective for patients and cost effective for taxpayers,” added Tauzin. “As lawmakers continue to look for ways to improve senior care and reduce Medicare costs, they need look no further than the Veterans Administration for a model that works extraordinarily well.”

Written by Alyssa Gerace

Alyssa Gerace