With reference to the Nov. 1 article on the prospective payment system for home healthcare (p. 10), given the assault on cash flow, morale and profitability the home healthcare industry has had to withstand-thanks largely to the infamous interim payment system courtesy of the federal Balanced Budget Act of 1997-it is inconceivable to me that under the proposed PPS, HCFA believes it's appropriate to fund only 50% of care after submission of the initial bill, with the balance to be paid at the end of the 60-day episode.
HCFA's next proposal for the home healthcare industry should be titled the "no payment system."
Home healthcare is labor-intensive, thus payroll-intensive. HCFA should realize that a business, especially one that does as much good for communities as home healthcare does, needs cash flow to fund operations, thrive and survive.
If HCFA wants a prospective methodology to work, it should put sufficient money on the line to provide for a successful transition. This component of the healthcare delivery system has already paid far too much for the abuses that select organizations may have inflicted on the system under the antiquated cost-based methodology. Simply stated, the savings under the IPS were enormous, especially compared with the original Congressional Budget Office projections for the budget act.
Let's use this comment period on the proposed regulations to ensure that HCFA will adequately fund these critical services and use this change to focus on preserving the well-being of our communities, as well as ensure that adequate systems exist to accommodate aging baby boomers.
Partner-in-charge, healthcare services
M.R. Weiser & Co.