Medicare reimbursement to home health agenices could be targeted for reduction as part of sweeping budget deficit deal that may be consisdered by Congress in 2013, according to Bill Dombi, vice president for law at the National Association for Home Care.

Dombi told me in a recent interview that the cuts could be based on Medicare Payment Advisory Commission recommendations to freeze rates and accelerate the four-year phase-in of rate rebasing for agencies.

"We would expect that Medicare home health will be on the target list in some form," Dombi said.

But Dombi said there is a growing recognition in Congress and the White House about the challenges facing home health given rate cuts already in place, combined with the regulatory compliance cost increases.

Among the short-term policy changes the industry is advocating that would save money is a moratorium on new home health agencies for those areas of the country already saturated with providers. "We have recommended a targeted moratorium for several years now and it will definitely reduce spending if done right," he said.