<p>Medicare Advantage was created to let private insurers deliver care to seniors. But as it turned out, Medicare Advantage enrollees are healthier than other Medicare subscribers, AND they cost us more per person. Instead of saving us money, Medicare Advantage is costing us money.</p>
<p>The ACA reined in this Medicare Advantage overpayment, to put Medicare Advantage and traditional Medicare on a level playing field. Speaking as a taxpayer, I’m all for it.</p>
<p>I’m not sure what this has to do with home health care.</p>
<p>Tatin, yes, that’s what all the industry origin articles say- it’s just so odd the primary detail is missing. That could still relate to, say, overbilling from MA plans or I don’t know what. </p>
<p>See, this is why I am confused on some news claims.
News Observer article by a home health clinician: “already resulting in a downturn in job growth, according to the U.S. Bureau of Labor Statistics.” Worrisome.</p>
<p>Can you give us a link not supplied by the industry, that explains what provision of the ACA makes these cuts and what the cuts are? Industries chirp about “cuts” but I’d like to know what actually is going on.</p>
<p>I’d add that this makes a lot more sense if you remember that the so-called “subsidy” is actually structured as a tax credit. In order to be eligible for the tax credit, a person needs to have the requisite taxable income. Immigrants whose status allows them to work in this country are also immigrants who are taxed on their earnings – and therefore eligible for the same possible deductions and credits as other taxpayers. </p>
<p>You’re right, I was confusing Medicaid eligibility with subsidy eligibility. Now that you point out that the subsidies are tax credits, it makes sense. Thanks.</p>
<p>Is the home care cut a cut? Or is it a reduction of revenue growth? </p>
<p>Almost Everyone in power was in favor of these medicare cuts at one time or another, but never at the same time. Or… People just want to spend the savings in different ways. </p>
<p>Arent these the projections after ACA passed?</p>
<p>This is an AP story. It seems that cutting Medicare for home health will not save money if it means that more of these people will become the ‘frequent fliers’, going to the hospital more, etc. </p>
<p>And don’t get me wrong. I am for saving the taxpayer’s money.</p>
<p>LF - I have no interest in arguing about ACA today, however since you have this vetting thing going on you should probably know that the AARP is an active ACA backer and Jonathon Gruber is one of it’s chief architects, although he is currently rather appalled at the botching of his baby. It’s hardly objective information.</p>
<p>Flossy. With trepidation, I linked to an article that says cuts in home health care. Beats one that included a misrep of BLS stats. But I’m getting tired of govt speak on this issue. I want to know if this is one of the things that fits my earlier comment: It’s not perfect. And how. How bad? And are we understanding this particular media talking point. That’s all. :(<br>
I can’t find anything that says what guaranteed benefits are except that you qualify at 65. </p>
<p>“Last year $62 billion — one out of every six dollars Medicare spent in the traditional fee-for-service program — went to nursing and therapy for patients in rehabilitation facilities, nursing homes, long-term care hospitals and in their own homes, according to a congressional advisory panel.<br>
Most of them got those services after coming out of the hospital. Some of these providers earn double-digit profits from Medicare through a hodgepodge of payment methods that health experts say encourages unnecessary and disjointed care, wastes taxpayer money and makes fraud easier. More than a quarter of Medicare spending in Louisiana, Texas, Mississippi, Oklahoma and Massachusetts was for post-acute care in 2011, Medicare records show.”</p>
<p>Yes. If someone wants what I am finding, I’ll link it. It’s intense. Re: Home Health Care, “Medicare’s Home Health Prospective Payment System (HH PPS)” from CMS.gov. If I can even put this right: apparently in 2000 they allocated based on 1997 data; in 2008 they revisited payments. But aiui they didn’t audit. And now they have. (They call it an update; audit is my word.) There’s a lot they wanted to consider and to factor in- and it is impressive (to me.) There is an attempt to rebase payments to the national schedule (with adjustments, depending.) There is an increase in the budget, but also corrections. And so, if I am getting this right, a cut. </p>
<p>dstark, the documents may be right up your alley. But you need time to get through them. You said, reduction of revenue growth? I was going to say reduction in fat growth. I think this is really an adjustment. Lots of loose ends. I’m done with this one. Fascinating.</p>
<p>They are not immigrants, here on work visas.</p>
<p>Don’t care to blame ACA but suffice it to say it went up around 21% and as a non-profit, there is no reason for us spend the money if government wants to subsidize people’s insurance. The subsidy is being funded by the taxes of people who are donating to the same organization.</p>
<p>The only question I am trying to get an answer to is whether it breaks laws to throw some people off the insurance while keeping those who can’t get a subsidy (only to make sure they have insurance and not taking a large pay increase and keeping it).</p>
<p>kmcmom - your solution is just not viable since we still want to ensure everyone is insured.</p>
<p>Texaspg – according to the list at healthcare.gov, individuals with “Non-immigrant Status (includes worker visas, student visas, and citizens of Micronesia, the Marshall Islands, and Palau)” qualify to buy marketplace insurance and get subsidies.</p>
<p>What am I missing here? Your employees with work visas are lawfully present in the US, so they qualify for subsidies.</p>
<p>I’d note that if there is a specific reason you are hiring individuals on work visas they may fit a different “class” of employee which allows you to legally set different conditions for their employment as well as to treat them differently when it comes to compensation and benefits. Do they have H1B visas? Those are supposed to be issued to individuals who have unique technical or specialty skills that can’t be filled with domestic workers… so in a small organization there might be a very clear way to differentiate them from the others. </p>
<p>There may also be alternate ways to insure those workers – they may qualify for short-term insurance coverage rather than regular insurance. If you are the sponsoring organization for the work visa, I’d think that buying short-term, visitor’s coverage for them might be very appropriate. </p>
<p>How long do these employees generally stay? The short-term coverage is generally geared to workers who are in employed for fixed periods of 12 months or less. </p>
Or… People just want to spend the savings in different ways. </p>