Oregon Home Health Care and Medicare

Floor Speech

By:  Greg Walden
Date: June 25, 2012
Location: Washington, DC

Mr. WALDEN. Mr. Speaker, I rise to address the House about an issue of particular importance to seniors and health care patients in Oregon's 70,000 square-mile Second District: access to home health care. Some counties in my largely rural district are without a single hospital or physician, meaning finding care can be difficult. Fortunately, however, each of the 20 counties in the district does have skilled, dedicated home health providers willing to care for those in need.

Ninety-six percent of all Medicare spending goes toward patients with more than one chronic disease, and sixty-six percent of the program's funds are used for those with five or more chronic conditions. With ten thousand new Medicare beneficiaries added every day, we must work to ensure the program's long-term sustainability.

Fortunately for Medicare, home health care providers go above and beyond to deliver high-quality, clinically effective, efficient care, and many medical treatments that were once offered in hospital or nursing home settings are now being safely and more cost-efficiently provided in patients' homes. Further, the home health and hospice industry helps fuel the economy with nearly 1.5 million jobs nation-wide.

I have seen first-hand the compassionate and highly skilled care home health nurses provide to patients. My wife Mylene and I have seen it on a personal level with our own families, and talked to numerous Oregonians who are grateful for the opportunity to recover in their own home with their spouse and loved ones by their side.

In addition to being good for patients, home health is also good for federal taxpayers. When seniors choose home health, they stay in their own beds, pay their own utilities, do their own laundry, and provide for their own meals. This is also often supplemented by family members who help keep them safe and well in the place they most want to be--their home. When Medicare covers the costs of room and board and 24 hour care in more expensive institutional settings, taxpayers spend thousands of dollars they would otherwise save in home health settings.

Unfortunately, however, for the majority of compassionate, skilled home health providers truly dedicated to the patients they serve, a narrow sliver of operators are tarnishing their good work. MedPAC has found that a small number of bad actors in just 25 counties nation wide are disproportionately taking advantage of Medicare beneficiaries and taxpayers.

According to MedPAC's figures, the total number of home health providers in these top 25 highest spending counties rose from 290 in 2005 to 775 in 2009, an increase of over 167 percent. During this time, Medicare payments to these providers went from $592 million to $1.6 billion, a 163 percent increase in taxpayer spending.

In Oregon during that same time period, the total number of providers, as well as overall Medicare reimbursement, actually decreased. These figures confirm what many of us in Oregon have been saying for years: when it comes to waste, fraud, and abuse in the health care system, Oregon providers as a whole are not the problem.

So while no State is 100 percent without fault, and while every provider should make it their goal to act only in the best interest of their patients, these figures have shown us the main source of abuse. Therefore, any future home health proposal should target these higher spending counties rather than indiscriminately harming the good players in the industry. Isolating and rooting out fraud simply makes sense for providers, patients, and taxpayers.

Mr. Speaker, while we can always do more to ensure access to health care services in rural areas like Oregon's Second District, I take comfort in knowing that there are many home health providers willing to serve seniors in Oregon and elsewhere. Because of these dedicated providers, patients receive the care they need in the comfort of their homes, with their families and loved ones at their side.

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