Medicare cuts threaten fast-growing home health care Costs climb too fast, Clinton, Congress agree


WASHINGTON -- Medicare spending on home health agencies and nursing homes has skyrocketed in the past five years, and Congress and the Clinton administration have decided that they must control those costs as part of any plan to balance the federal budget.

Home health care is one of the fastest-growing benefits in the Medicare program, and Medicare, in turn, is the largest purchaser of home health services in the United States.

Medicare spending for such services, which are provided by nurses, home health aides and therapists, has increased 31 percent a year, to $16.7 billion in 1996 from $3.3 billion in 1990.

And Medicare payments to skilled nursing homes rose 26 percent a year, to $11.1 billion in 1996 from $2.8 billion in 1990.

Medicare patients, who are elderly or disabled, like the home health benefit because it allows them to receive care without traveling to a doctor's office or hospital. In fact, they must be homebound to qualify.

But Donna E. Shalala, the secretary of health and human services, said some of the spending was clearly inappropriate.

"Our recent investigations in several states show that 25 percent to 40 percent of home health visits paid for by Medicare were for services that were either never delivered or were provided to people who did not qualify for those services," Shalala said.

The people who receive home health services are typically women older than 75. But growing numbers are disabled people younger than 65.

In his new budget, President Clinton proposes to cut $100 billion, or 7 percent, from the $1.35 trillion that would otherwise be spent on Medicare in the next five years.

He would cut payments to home health agencies by $14 billion and would squeeze $7 billion from nursing homes.

Pub Date: 2/09/97

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