Pennsylvania Homecare Association
HARRISBURG, Pa., March 17 -- In 2003, the last time the Commonwealth
increased its reimbursement to home health care providers, gasoline
was selling for $1.35 a gallon. Today, with gasoline at $3.30 and more
in many parts of Pennsylvania, homecare agencies are still getting the
same $77 per home visit and eating the skyrocketing cost of fuel or
cutting corners in other areas. And, according to the Pennsylvania
Homecare Association, providers are fresh out of corners to cut.
Homecare has been hailed by Gov. Edward G. Rendell as the "next big
thing" to keep down the costs of health care by providing quality
service, personal attention, and nursing skills without the overhead
of large bricks-and-mortar institutions. But critical funding has not
yet followed favorable reviews. The Commonwealth has increased the
payment for home health care Medicaid recipients just once in the past
16 years. The current Medicaid reimbursement rate is $77, while the
actual average cost per home visit according to a two- year-old study
-- is $118, a $41 loss every time a nurse provides care to a patient.
Record high gasoline prices have made the gap even wider.
"According to a University of Pittsburgh study, a typical registered
or practical nurse making home calls can expect to drive a total of 60
miles a day between appointments," said Vicki Hoak, executive director
of the Pennsylvania Homecare Association. "You can do the math. Figure
an average of 20 miles per gallon for the nurse's car and that works
out to three gallons of gas a day just getting between patient homes.
That's $9.90 they must pay just for gasoline -- but the typical
homecare agency reimburses the staffer at the Internal Revenue Service
rate of 50.5 cents a mile -- or $30. It's not a number that our
providers can swallow or ignore."
With a loss for services already stretching homecare agency budgets,
Medicare and private pay customers help to offset costs and reduce
monetary losses for the agencies, allowing them to stay in business.
According to the State of the Homecare Industry in Pennsylvania
report, released last year by the University of Pittsburgh, homecare
agencies staff, including nurses, physical, speech, and occupational
therapists and home health aides traveled 210 million miles in 2005.
The Pennsylvania Homecare Association is seeking a $10 million
increase in the state's 2008-09 budget allocation to increase the
Medicaid reimbursement to $100 per visit for skilled services. The
increase will help offset the cost of nursing and therapeutic care,
rising gasoline prices, and workers' compensation premiums for home
health agencies. Last year alone, Pennsylvania home health agencies
spent an additional $6.7 million to help cover the rising gasoline
costs.
"On any given day, a home health nurse sees five patients a day,
averaging 12 miles per day between each patients home. Mileage can be
even higher if a nurse is working in a rural area of the state," said
Hoak. From the $77 reimbursement amount provided by Medicaid for a
nursing visit, agencies pay salaries, mileage, workers compensation,
insurance premiums for employees, medical supplies, and many other
overhead costs. "In addition to the increase in gasoline prices, our
cost of doing business has risen 15 to 25 percent since the last
increase."
Medicaid provides basic health care for low-income individuals under
the age of 60 and for the elderly under the state's Aging Waiver
program. Nearly two million people are covered by Medicaid in
Pennsylvania, but only about 10,000 of those receive at-home health
care and another 12,000 people under the Aging Waiver, she said. "It's
clear that the Governor would like that number to grow because even at
$100 per visit, homecare is less costly than hospital or nursing home
care," Hoak said. "But our members can't afford to shoulder an even
larger caseload and more losses."
Hoak called the situation the "invisible crisis."
"Unlike other healthcare providers, home health care is invisible to
the community at large. We don't have any big, imposing edifices to
drive by daily. We're the quiet solution," Hoak said. "We're critical
when it comes to helping people stay out of hospitals and nursing
homes. And we're cost effective: To provide in-home care to a senior
citizen so that they don't have to go to a nursing home costs Medicaid
$23,000 compared to Medicaid's cost for a person in a nursing home at
$56,000 a year."
The Pennsylvania Homecare Association is headquartered just outside of
Harrisburg and represents more than 300 agencies that deliver care and
support directly in the homes of more than a million elderly and
disabled citizens in the state of Pennsylvania. To learn more about
in-home care, visit the PHA website at http://www.pahomecare.org.
SOURCE Pennsylvania Homecare Association
Eric Kiehl, Public Affairs Director of Pennsylvania Homecare
Association, +1-800-382-1211 ext. 26, or mobile, +1-717-422-2025,
ekiehl@pahomecare.org,
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