[Congressional Record (Bound Edition), Volume 159 (2013), Part 4]
[Extensions of Remarks]
[Pages 5773-5774]
[From the U.S. Government Publishing Office, www.gpo.gov]




    PROTECTING ACCESS TO HIGH QUALITY AND COST EFFECTIVE HEALTHCARE 
                                SERVICES

                                 ______
                                 

                          HON. MARK E. AMODEI

                               of nevada

                    in the house of representatives

                        Tuesday, April 23, 2013

  Mr. AMODEI. Mr. Speaker, true healthcare reform will lower costs, 
improve care, provide greater patient choice, and increase access to 
care for all Americans. Congress missed an opportunity in 2010 to 
achieve these goals in the extensive legislation enacted by Democrats. 
As a result, we must go back to the drawing board and consider real 
options to address the rising costs in our healthcare system. As we 
pursue these goals, we should look to solutions that have already been 
effective in reducing costs and meeting the needs of patients.
  Skilled home healthcare is one example of the type of effective care 
that Congress should protect. In 1972, the U.S. Department of Veterans 
Affairs established the Home Based Primary Care Program (HBPC) in order 
to meet the needs of its growing population of chronically ill 
veterans. This program established a novel and creative model of care 
for the VA's growing population of chronically ill Veterans--providing 
skilled and high quality care to these patients, and promoting their 
independence by providing this care to patients in their own homes.
  The results of this program have been remarkable. Studies show that 
this program has provided high quality care and resulted in great 
satisfaction among patients. What is truly impressive, though, is that 
this program resulted in a substantial reduction in nursing home stays 
and hospitalizations for its program participants. The HBPC has 
achieved a

[[Page 5774]]

62 percent reduction in inpatient hospital days and an 88 percent 
reduction in nursing home days, achieving a 24 percent REDUCTION IN 
TOTAL COSTS.
  I am not aware of any reform to our healthcare system or to Medicare 
that has ever achieved similar results. We must reform the Medicare 
program because it is not solvent in its current form, and will reach 
insolvency by 2024. As we consider reform to the Medicare program, I 
believe that we should be incentivizing cost-effective and high quality 
services that show results. I urge my colleagues to look to the success 
of the HBPC at the Veterans Administration as a possible model for how 
Medicare can provide high quality care and lower costs.
  Forty years of data from the HBPC program proves that many medical 
treatments that were once offered only in a hospital or a physician's 
office are now being safely, effectively, and much more cost-
efficiently provided in patients' homes. These services are typically 
less expensive, more convenient, and as effective as care provided in a 
hospital or skilled nursing facility. The success of the Home Based 
Primary Care program at the VA is evidence that skilled home healthcare 
not only is good for seniors, but also good for taxpayers. Mr. Speaker, 
skilled home healthcare is an asset that we need to fully utilize in 
order to further reduce costs in our Nation's healthcare system. As 
Congress works to improve our healthcare delivery system, we should 
avoid changes to the Medicare program that would limit patient access 
to proven and cost effective services like skilled home healthcare.

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