National Association of Home Care & Hospice

National Association of Home Care & Hospice
Name	National Association of Home Care & Hospice
Abbreviation	NAHC
Formation	1982
Type	Trade association
Headquarters	Washington, D.C.
Region served	United States
Membership	Home health agencies, hospice providers, home care aides
Leader title	President and CEO

National Association of Home Care & Hospice is a United States trade association representing private and public home health agencys, hospice providers, and related long-term care organizations. Founded in the early 1980s amid regulatory change following the Medicare Hospice Benefit and shifts in Health Maintenance Organization policy, the organization acts as an industry advocate, standards developer, and educator for members facing compliance with Centers for Medicare & Medicaid Services rules and state-level licensure.

History

The association emerged during debates about reimbursement reforms after passage of the Social Security Act amendments that created the modern Medicare hospice framework and influenced the rise of managed care in the 1980s. Early leaders included executives from major home health firms connected to the American Hospital Association and the National Association for Home Care & Hospice predecessor organizations that responded to changes from the Prospective Payment System for hospitals and the development of Home Health Prospective Payment System. Over decades the association engaged with policymakers in Congress and federal agencies such as the Centers for Medicare & Medicaid Services and the Department of Health and Human Services, while interacting with other stakeholders including the American Nurses Association, Visiting Nurse Associations of America, and national hospice coalitions formed after landmark cases like Cruzan v. Director, Missouri Department of Health influenced end-of-life care debates.

Mission and Advocacy

The group's stated mission focuses on supporting members through advocacy on reimbursement, regulation, and quality measurement associated with programs like Medicare Advantage, Medicaid, and the Social Security Act. It actively participates in rulemaking tied to the Balanced Budget Act of 1997, the Patient Protection and Affordable Care Act, and subsequent regulatory actions by the Centers for Medicare & Medicaid Services. The association liaises with legislative committees such as the United States House Committee on Ways and Means and the United States Senate Committee on Finance and collaborates with professional organizations like the American Medical Association and the National Association of Social Workers to shape policy affecting home-based hospice and post-acute care.

Membership and Governance

Membership spans independent home health agencys, proprietary hospice systems, nonprofit providers, and allied vendors that serve clinical and administrative functions; members often have relationships with hospital systems like Mayo Clinic and integrated delivery networks such as Kaiser Permanente. Governance typically follows a board of directors model with representatives from large chains, regional providers, and clinician-led agencies, echoing corporate governance practices seen in trade groups like the American Hospital Association and the National Rural Health Association. Executive leadership engages with state associations including the California Association for Health Services at Home and national accrediting bodies such as the Joint Commission.

Programs and Services

The association offers education, conferences, and technical assistance similar to offerings from Hospice and Palliative Nurses Association and National Hospice and Palliative Care Organization, with annual meetings that attract vendors known in the sector, including firms like Kindred Healthcare and Amedisys. Programs address clinical practice, regulatory compliance related to Occupational Safety and Health Administration standards, billing aligned with Centers for Medicare & Medicaid Services guidance, and workforce development initiatives paralleling efforts by the Institute for Healthcare Improvement and the RAND Corporation on quality measurement. It also provides member services for cybersecurity guidance that intersect with standards promoted by National Institute of Standards and Technology.

Standards, Certification, and Education

The association develops model policies and educational curricula referencing clinical standards from the American Nurses Association, ethical frameworks influenced by rulings like Washington v. Glucksberg, and quality metrics comparable to those used by the National Quality Forum. While not an accreditor like the Joint Commission or the Community Health Accreditation Partner, it offers competency assessments, continuing education credits that align with licensing boards and professional bodies such as the Commission on Accreditation of Rehabilitation Facilities, and publishes guidance on documentation responsive to Health Insurance Portability and Accountability Act requirements and federal survey processes.

Policy Influence and Lobbying

The organization maintains a government affairs operation that files comments during rulemaking at the Department of Health and Human Services and participates in coalitions with groups like the American Hospital Association and the LeadingAge consortium. It advocates on payment reform within the Centers for Medicare & Medicaid Services rulemaking cycle, engages lobbying firms familiar with U.S. Congress appropriations and authorization processes, and issues position papers addressing statutes including provisions of the Balanced Budget Refinement Act and amendments to the Social Security Act. Its advocacy intersects with debates over the future of Medicare Advantage and post-acute care payment models promoted by think tanks such as the Brookings Institution and the Heritage Foundation.

Criticisms and Controversies

Critics have raised concerns similar to critiques leveled at large industry associations like AARP and the Chamber of Commerce regarding lobbying influence on Medicare policy and potential conflicts between profit motives and care quality, citing cases where large provider chains such as Encompass Health and others faced scrutiny over billing and clinical practices. Controversies have involved debates on transparency, the role of for-profit providers in hospice, and responsiveness to workforce shortages highlighted in reports by the Government Accountability Office and analyses from the Kaiser Family Foundation. Investigations and policy disputes sometimes lead to tensions with patient advocacy groups and regulatory agencies like the Office of Inspector General (HHS).

Category:Health care trade associations