Statements on Introduced Bills and Joint Resolutions
STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS -- (Senate - February 07, 2005)
By Ms. COLLINS (for herself, Mr. FEINGOLD, Mr. LUGAR, Ms. LANDRIEU, Mr. BURNS, Ms. MURKOWSKI, Mr. BOND, Mr. THOMAS, Mr. COCHRAN, Mr. SANTORUM, Mrs. LINCOLN, Mr. JEFFORDS, Mr. CONRAD, and Mr. LEAHY):
S. 300. A bill to extend the temporary increase in payments under the medicare program for home health services furnished in a rural area; to the Committee on Finance.
Ms. COLLINS. Mr. President, I rise today to introduce the Medicare Rural Home Health Payment Fairness Act to extend the additional payment for home health services in rural areas for 2 years. This 5 percent add-on payment is currently scheduled to sunset on April 1st of this year.
Home health has become an increasingly important part of our health care system. The kinds of highly skilled-and often technically complex-services that our Nation's home health caregivers provide have enabled millions of our most frail and vulnerable older and disabled citizens to avoid hospitals and nursing homes and stay just where they want to be-in the comfort and security of their own homes. I have accompanied several of Maine's caring home health nurses on their visits to some of their patients. I have seen first hand the difference that they are making for Maine's elderly.
Surveys have shown that the delivery of home health services in rural areas can be as much as 12 to 15 percent more costly because of the extra travel time required to cover long distances between patients, higher transportation expenses, and other factors. Because of the longer travel times, rural caregivers are unable to make as many visits in a day as their urban counterpart s. The Executive Director of the Visiting Nurses of Aroostook in Northern Maine, where I am from, tells me her agency covers 6,600 square miles with a population of only 73,000. Her costs are understandably much higher than other agencies' due to the long distances her staff must drive to see clients. Moreover, her staff is not able to see as many patients in one day as she would like.
Agencies in rural areas are also frequently smaller than their urban counterparts, which means that their relative costs are higher. Smaller agencies with fewer patients and fewer visits mean that fixed costs, particularly those associated with meeting regulatory requirements, are spread over a much smaller number of patients and visits, increasing overall per-patient and per-visit costs.
Moreover, in many rural areas, home health agencies are the primary caregivers for homebound beneficiaries with limited access to transportation. These rural patients often require more time and care than their urban counterparts, and are understandably more expensive for agencies to serve. If the extra rural payment is not extended, agencies may be forced to make decisions not to accept rural patients with greater care needs. That could translate into less access to health care for ill, homebound seniors. The result also would likely be that these seniors would be hospitalized more frequently and would have to seek care in nursing homes, adding considerable cost to the system.
Failure to extend the rural add-on payment will only put more pressure on rural home health agencies that are already operating on very narrow margins and could force some of these agencies to close their doors altogether. Many home health agencies operating in rural areas are the only home health providers in large geographic areas. If any of these agencies were forced to close, the Medicare patients in that region could lose all their access to home care.
The bipartisan legislation that I am introducing today with Senators FEINGOLD, LUGAR, BOND, LANDRIEU, BURNS, MURKOWSKI, THOMAS, COCHRAN, SANTORUM, LINCOLN, JEFFORDS, CONRAD and LEAHY will help to ensure that Medicare patients in rural areas continue to have access to the home health services they need. I urge all of our colleagues to join us as cosponsors.
http://thomas.loc.gov