March 25, 2012 -- Health care leaders from throughout Westchester and Putnam counties gathered in White Plains last week to hear William Dombi, vice president for law at the National Association for Home Care and Hospice and director of the Center for Health Care Law, discuss changes in federal health care regulations and the challenges and opportunities they present for local providers.

The forum was one in a series of educational events hosted by Visiting Nurse Services in Westchester& Putnam, the largest independent, community-based not-for-profit home health care agency in both counties.

Dombi outlined many of the provisions of The Patient Protection and Affordable Care Act (ACA) including those that call for new ways to improve the quality and efficiency of health care: “Community-based home care is the future of health care in the United States,” Dombi said. “Medical advances have greatly extended average life expectancy but costly chronic illnesses persist and require a new approach to health care management and funding. Home care is the key to containing costs and improving patient outcomes and quality of life. Thanks to advanced medical and communications technology there are virtually no limits to the kind of care that can be delivered in a home setting."

With over 30 years of experience in health care law and policy, Dombi has been involved in virtually every legislative and regulatory effort affecting home care and hospice since 1975, including the massive health care reform legislation of 2010. He also served as lead counsel in the landmark lawsuit that reformed the Medicare home health services benefit.

Organizations like Visiting Nurse Services in Westchester& Putnam are models for the home health care movement, Dombi said. “Visiting nurses are coaches, not just clinicians. They work in partnership with clients and really illustrate the clinical benefits of the human element of health care. These nurses are incredibly special people.”

Elias “Lou” Nemnom, President & CEO, Westchester Visiting Nurse Services Group, Inc., parent company of Visiting Nurse Services in Westchester& Putnamand its home health aide affiliate Westchester Care at Home, said the need for home healthcare is especially great in Westchester County where 1 in 5 residents are 65 or older. “Our ongoing investment in state-of-the-art technology allows our nurses and home health aides to provide services that previously required lengthy and costly hospitalization," he said. "Moreover, VNS Westchester services have greatly reduced the incidence of re-hospitalizations and increased the health and well-being of residents in our service areas.”

Among the challenges Dombi sees in current and anticipated federal health care legislation are the recalculation of Medicaid payment rates, increased oversight and regulation which will increase administrative costs for service providers, and new Medicare deductibles and co-payments which he fears will create a barrier to care.

“By 2013, payment rates to Medicare service providers will be lower than they were in 2008,” he said. “Far reaching and systemic Medicare reform will be the number one issue on the federal agenda in 2013 no matter who is sitting in the White House or serving in Congress. Every metric says that Medicare is going bankrupt and has to be fixed.”

Dombi encouraged area healthcare providers to engage themselves in the dialogue and become politically active so that they will have a voice in the changes that are on the horizon.