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2021 Post-Election Implications for Home-Based Care Health Policy – An Insider’s View


The recent elections were historic on many levels.

While the election results were not immediately clear, the message from the American voters was. Access to healthcare, particularly during a worldwide pandemic, is paramount. Republicans and Democrats alike sent a mandate to the incoming president and members of Congress that affordable, quality healthcare is a top priority, and healthcare delivery in the home is critical to addressing the needs of COVID-19 patients and controlling the spread.

Andrew Woods, Chairman of Liberty Partners Group, an attorney and Washington insider, sat down with me a few days post-election to share his projections on what the home-based care industry can expect in 2021.

And it’s good news for healthcare professionals.

Will There Be Another COVID-19 Relief Bill Before the End of 2020?

Congress has passed three federal COVID-19 relief bills to date, but with no end to the coronavirus pandemic in sight, many political leaders believe that a fourth is close to passage.

With re-elected Senate Majority Leader Mitch McConnell calling for a relief package by the end of 2020, and a Republican-controlled Senate eager to pass a COVID-19 bill while their majority is certain, Woods is confident that the odds are in Americans’ favor and he “…would be surprised if [President Trump] doesn’t sign it.”

And what might the future of the COVID-19 regulations be for home health and hospice providers in 2021?

“Relaxed” regulations, like allowing telehealth home health visits in place of mandatory in-person visits, and allowing nurse practitioners to certify home health orders, were all granted under the Trump Administration. Woods doesn’t anticipate the incoming administration will reverse these regulatory practices and expects CMS to extend these easements for providers beyond the current COVID-19 emergency period ending in January.

What Other Healthcare Changes Are Expected?

A recent poll shows that 26% of voters think healthcare is the most important factor in choosing a president.

It’s no surprise then that plans are already underway by the Biden administration to refocus the direction of our nation’s healthcare to meet voters’ expectations.

President-Elect Biden has already begun to establish a COVID-19 task force with experts from previous administrations and the scientific community. Biden has declared the COVID-19 pandemic as his top priority. Stringent federal guidelines for states and the American public regarding mask-wearing and prevention may be released as soon as late January.

Other important national health policy action has taken place with the U.S. Supreme Court hearing oral arguments to determine the future of the Affordable Care Act (ACA) and its potential impact on millions of Americans that receive health coverage under existing law. Resulting action wouldn’t be determined for many months; however, Democrats will no doubt advocate strongly to retain and strengthen the ACA to ensure coverage for the uninsured and the most vulnerable in our country.

What Is the future of Medicare and Medicaid?

While both of these federal health insurance plans are costly to taxpayers, Woods doesn’t see either of them cutting benefits or reducing their beneficiary roles. In fact, CMS recently announced their plans to standardize and strengthen Medicaid, particularly for home and community-based services (HCBS).

On the Medicare front, with 10,000 Americans reaching the eligibility age of 65 each day in our nation, Democrats have hinted about proposing legislation to lower Medicare eligibility to age 60 or 55. The reasoning? According to Woods, “If you have healthier people in the Medicare system paying in with monthly premiums but aren’t causing an expense to the system because they are relatively healthy and aren’t accessing services, they’re generating revenue to pay for the services that are needed for the elderly population that uses a disproportionate share, particularly towards the end of life.”

“And don’t worry about the Medicare and Medicaid well drying up,” according to Woods. “Neither party will allow it to happen. The argument will inevitably focus on where to pull funding from.”

Therefore, what might lowering the eligibility age of Medicare do to provider reimbursement rates?

Historically, Biden’s healthcare advisors who worked with Presidents Clinton and Obama, increased reimbursements for new healthcare technologies and drugs. Knowing this, it’s safe to predict the Biden administration will consider similar efficiencies in the system and reward the providers who enable it. Biden has also expressed his appreciation for home care workers and the value of care in the home. This opens up the opportunity for our industry to advocate for additional reimbursement to support in-home staff and increase efficiencies.

The Growth of Technology in Healthcare

Axxess is a technology partner with home health, hospice and home care organizations. With the current public health emergency highlighting the ease and preferability of healthcare technology, it’s inevitable that we will see technology playing a more important role in the delivery of home-based care.

Enter the HEAT Act, urgently in need of support.

According to Woods, “There has been talk from members of Congress about creating an “omnibus” bill passed by the end of the year which could be the vehicle to incorporate the HEAT Act. But an omnibus has not yet been drafted. The HEAT Act is currently the only legislation fighting for telehealth provider reimbursement and will likely have significant support but needs a vehicle to get it over the finish line this year.”

We Are All Advocates for Home-Based Care

To achieve the goal of increased healthcare delivery in the home, we need as many individuals as possible to actively engage in grassroots advocacy, in tandem with our national associations and lobbyists to advance our issues in Washington D.C.

Every voice is crucial to ensuring individuals receive the healthcare that they need and providers have the reimbursement and regulatory environment to deliver care to ensure that the future of healthcare is where people prefer most – in the home.

Watch the analysis for additional details and insights.

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