Home Care Group Pushes for ‘Home First’ Policies

A national home care partnership, which counts Addus HomeCare (Nasdaq: ADUS) and Bayada Home Health Care as members, is urging the Trump administration and Congress to improve and modernize the Medicaid program and expand access to home-based care and services.

The Partnership for Medicaid Home-Based Care (PMHC) issued a statement Wednesday outlining its “Home First” recommendations, which would “ensure individuals are offered homebased care and services if they qualify for and desire such placement, rather than being summarily routed to a nursing home setting,” the group said.

PMHC is comprised of home health agencies, associations, tech vendors and payers, and aims to weigh in on Medicaid policy as it relates to home-based services.


The statement comes amid a renewed push for a health care regulatory overhaul. A new bill to overturn the Affordable Care Act (ACA) recently introduced by House Republicans could substantially impact the current Medicaid program by gutting federal spending, if approved and signed into law.

Putting home care first

PMHC’s wish list includes a call to rebalance Medicaid mandates so home health care services are on “equal footing” with nursing home care. The federal government could do that by reducing states’ reliance on Medicaid waivers or expanding presumptive eligibility and spend-down policies to include beneficiaries receiving home care, the group said.


“The basic structure of the Medicaid program makes access to institutional services the default and services in the home and community the exception,” PMHC Chairman David Totaro said in a statement.

Another PMHC desire is to expand access to long-term services for beneficiaries who are dually eligible for Medicaid and Medicare. This could be achieved by supporting improvements such as allowing shared cost savings between Medicare and Medicaid, PMHC wrote.

The group also is calling for better use of smart home technology—like the kind already in use by private payers and Medicare Advantage plans—to cut down on unnecessary hospitalizations.

Other desired overhauls include updates to housing tax credits and vouchers; general improvements like the Electronic Visit Verification (EVV) systems, better qualification standards for personal care aides, and standardized payment rules; and the preservation of programs such as Community First Choice Option and Money Follows the Person, which both give states incentives for servicing people in their homes rather than in a nursing home or medical facility.

“By strengthening Medicaid recipients’ access to high-quality, lower-cost, consumer-preferred home and community-based services, we are confident these reforms can improve selfdetermination, outcomes, along with increased quality of life and satisfaction, and significantly reduce program costs,” Totaro said.

Written by Tim Regan

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