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Paul Bartoletti discusses homecare and hospice issues with Sen. Bob Casey during the Pennsylvania Homecare Association’s Lobby Day last year in Washington, D.C.

A northeastern Pennsylvania businessman has been leading the way when it comes to home health care across the state as head of the Pennsylvania Homecare Association (PHA) for the past two years.
“It’s a great organization and a great honor to be a elected,” said Paul Bartoletti, president and CEO of CareGivers America. He began his term two years ago. The PHA is a state trade association that represents more than 500 organizations across the state that gives homecare to individuals.
“At PHA, we promote our industry,” he said. “Homecare is pretty new. It includes nonmedical care like laundry, housekeeping, meals, companionship and personal care. It’s become very important in keeping elderly and disabled people home.” He said in Pennsylvania, there are about 1,600 homecare licenses. “It’s become widespread,” he said of industry growth.
The group also advocates on behalf of patients and consumers and works on legislation, as well as business issues that face homecare organizations.
“We’re trying to balance the effort of nursing home money and homecare money in the state,” he said. “It’s more cost effective to be at home and it makes sense because people would prefer to stay home and be cared for there.”
He said PHA also does education for member agencies — everything from business education to computer classes to help people run their business.
Bartoletti said PHA is bracing its members for changes from the Affordable Care Act passed by Congress and signed by the president in 2010, the legislation also known as “ObamaCare.”
“We recently set up a steering committee to see how the Affordable Care Act is going to change things,” he said. “One issue we are really looking at is how you’re going to get paid.”
Bartoletti has taken note of payments that will go to so-called Accountable Care Organizations, or ACOs. Accountable Care Organizations (ACOs) are groups of doctors, hospitals, and other health-care providers, who come together voluntarily to give coordinated high quality care to their Medicare patients. The goal of coordinated care is to ensure that patients, especially the chronically ill, get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors. When an ACO succeeds both in both delivering high-quality care and spending health-care dollars more wisely, it will share in the savings it achieves for the Medicare program.
“ACOs are organizations that will act as partnerships that will examine each situation,” Bartoletti said, “In many cases, home-care organizations will keep people out of the hospital and still get them great care. By joining together and forming these partnerships, we’ll get paid on an outcome basis. (The feds) were really pushing that concept and that’s coming down the pike.”
Bartoletti said the ACO concept does not frighten him. “I believe the best thing to do is to pay for health care based on outcomes — to have a cooperative type of system where people work together to keep people healthy and out of the hospitals,” he said. “Will there pains? Absolutely, and I think smaller and independent players will get pushed out over time.”
Bartoletti said another thing to look for is managed care.
“People who have a low income or Medicaid, they are now enrolled in managed care organizations, who will work with these people to try and keep them in their homes and to try and work with them to help them create a healthier lifestyle.”
“At the end of the day, health care begins in the home,” he said. “Home health providers are able to educate patients and tell them the benefits of hospice, home health and homecare.”