ROANOKE TIMES
Copyright (c) 1997, Roanoke Times
DATE: Friday, January 17, 1997 TAG: 9701170091
SECTION: NATIONAL/INTERNATIONAL PAGE: B-4 EDITION: METRO
DATELINE: WASHINGTON
SOURCE: Los Angeles Times and The Associated Press
Alarmed by runaway costs, the Clinton administration plans to cut back on health care that many elderly Medicare recipients receive at home.
The administration's proposed fiscal 1998 budget, to be released Feb.6, would place strict new limits on payments for home health care, the fastest growing part of Medicare. An increasing number of elderly invalids and shut-ins seek to get nursing care, physical therapy and help with dressing and bathing at home.
Government costs for the care are climbing at 23 percent a year, far exceeding the 9percent overall growth rate in the total Medicare program.
``We are trying to get a handle on what is a considerable growth problem,'' an administration official said Thursday, noting that the number of home visits virtually exploded from 31million in 1984 to 209 million in 1994. ``Volume has gone through the roof, and there is clearly some excess,'' he said.
The proposal reflects the delicate nature of efforts under way to wring savings from Medicare without drawing all-out opposition from the elderly, whose powerful lobby is capable of igniting a political firestorm.
The administration proposal would cut reimbursement to home health agencies in the short run - over the next two years. For 2000 and beyond, the government would try to develop a system that pays fixed amounts based on the nature of an ailment and its duration.
Beneficiaries now can get as many as 35 hours a week of care at home for virtually unlimited periods of time. The government will pay for services ``as long as they are considered medically reasonable and necessary,'' according to Medicare's home health guidebook. The beneficiary must be home-bound and have a condition requiring skilled care.
The administration also plans to offer Medicare recipients free mammograms, respite care for Alzheimer's patients and screenings for diabetes and colon cancer, an administration official said Thursday.
Despite the new benefits, the plan to revamp Medicare would produce savings of $100 billion over five years, most of it from cutting fees paid to hospitals, doctors and health maintenance organizations, the official said.
The preventive care measures should save money in the future by catching diseases early, but the proposal, part of a plan to balance the federal budget by 2002, does not include such savings in its projection, said the official, who spoke on condition of anonymity.
Women could get free mammograms every two years, and Alzheimer's victims would qualify for 24-hour home care while their families take a break from caring for them, the official said.
The administration also wants more money for rural counties, which have complained they are shortchanged under current funding formulas.
About $20 billion of savings in Medicare would come from cutting payments to HMOs. The federal government now pays HMOs 95 percent of the cost of treating an average beneficiary in the county. The administration plans to cut that to 90 percent, the official said.
LENGTH: Medium: 61 linesby CNB