OAHC Position Paper

Home health care brings proven cost savings to health care, promotes better patient outcomes, provides access to the latest therapies and medical technology, and is the patient preferred setting for medical care, as was exposed due to the pandemic. The Oregon Legislature and Congress should protect and expand access to home health care, eliminate barriers to its provision, and work to expand its use as an effective solution to rising health care costs and an effective way to manage patient health in this crisis.

The Oregon Association for Home Care (OAHC), in our effort to preserve access and quality of care in the delivery of home care, has identified the following State and Federal priorities for 2023 and beyond.

State Priorities

• Continue to advocate for home health exemption from the nurse staffing bill, HB 2697
• Protect Medicaid funding to ensure Oregonians have access to home health care to stay out of hospitals and nursing homes. Ensure biennial rates are established as previously set by the legislature.
• Support legislation that would ensure access to palliative care in the continuum of care.
• Advocate for fair and reasonable employment standards that do not open providers up to liability exposure, particularly the Private Attorneys General Act, which would have permitted individuals to sue businesses on behalf of the state under any statute that includes a civil penalty.
• Advocate for responsible state regulations that do not add barriers to access to care commensurate with issued federal guidelines and limit additional state requirements for home health providers. Monitor and engage on burdensome employment requirements and proposals that increase costs for agencies.
• Continue to advocate for telehealth for managing home health patients.
• Support legislation and regulations that make in-home care, home health and hospice accessible and streamlined for patients and their families, particularly those in rural communities with less access to traditional health care service models.
• Monitored legislation that would have limited a provider’s ability to provide appropriate care based on patient demographics.

Federal Priorities

• Workforce
• Require medical residents and other professional licensed staff to have home care and hospice experience as part of their education
• Provide sufficient home care and hospice payments so that agencies can provide appropriate wages and benefits to caregiving staff
• Ensure availability of home care and hospice personnel to meet the growing needs of the baby boom generation, particularly in rural, inner city, and other underserved areas
• Support efforts to meet the growing need for trained palliative care professionals
• Home Health
• Ensure that Medicare home health payment model revisions provide fair and reasonable reimbursement to maintain access to care
• Ensure adequate reimbursement from Medicare Advantage Plans for home health services
• Pursue market basket update reforms that better reflect actual costs of providing care
• Hospice
• Enact hospice-specific program integrity & compliance measures
• Protect integrity of the Medicare Hospice Benefit by averting major payment cuts or structural changes that will reduce access to care
• Medicaid
• Support tax incentives for family caregivers
• Ensure appropriate Medicaid rates for home care and hospice
• Innovation
• Establish new home- and community-based palliative care delivery and payment demonstration to address the needs of seriously-ill Medicare and Medicaid Patients
• Incentivize home health and hospice interoperability and establish standards to facilitate data exchange with hospitals, physicians, and other provider types
• Ensure accessibility and promote use of advance care planning counseling, advance directives, and other advance care planning documents
• Support home-based alternatives to the Medicare skilled nursing facility benefit
• Remove barriers to the use of remote patient monitoring and telehealth services in the home