The Balance Budget Act (BBA) of 1997 made substantial changes to nearly all aspects of the Medicare program to contain spending. The Act was the largest reductions in federal Medicaid spending in Medicaid since 1981. It was expected that the Act will achieve a gross federal Medicaid savings of $17 billion over five years and $61.4 billion in ten years. After the legislation 's offsetting increases in Medicaid spending are accounted for, there was a further anticipation of a net federal Medicaid savings of $7.3 billion over the next five years and $36.9 billion over the next ten years. Some revision to the Act was made in 1999 but the key provisions were as follows.
• GME training payment reform (eg, cap on number of residents, reduction in
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In other words, Medicare costs for home health services declined which resulted in a drop in total Medicare costs. However, hospice costs increased but there was no discernable effect on mortality rates.
The Balanced Budget Act of 1997 dramatically reformed the Medicare home health benefit. The budget agreement had measures aimed at achieving savings of $17 billion in five years. The Balanced Budget Act also includes other provisions that go a long way to strengthen and preserve the benefit, including the surety bond requirement and the venipuncture provision.
Given the rapid growth in healthcare needs alongside the waste, fraud and abuse of benefit major changes are necessary. But often change comes challenges and the Balanced Budget Act is no exception. All the stakeholders in healthcare are therefore encouraged to actively participate in carry out the changes that will help safeguard the benefit.
In view, the BBA was successful in containing the costs of home health services and resulted in savings in overall costs of care for older cancer patients. However, the drop in utilization of home health services did not seem to negatively affect outcomes. The BBA may have contributed to the trend of increasing use of hospice