The survey was designed to test senior support for the CMS pre-claim review system, now in the demonstration period. Any physician prescribing home-based treatment would have to submit a description of the plan of care to a federal home health agency for review.

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Home health care services have been expanding as the medical profession learns more about best practices for treating older patients, especially those who have been recently released from a hospitalization.

These "transitional services" include not just medical care such as prescription drugs and therapy, but care coordination services that ensure that physician orders made at the time of release from the hospital follow the patient into the home.

Survey respondents were adamant that any government review required of these home health care services would not be in their best interest. In addition to the overwhelming opposition to the review process in general, seniors had the following to say about details of the process:

• 80 percent think it is likely that requiring a government contractor to approve claims for Medicare home health care services will result in delayed care for patients in need of prompt care.

• 77 percent think requiring a government contractor to approve care will increase the cost of Medicare services.

• 75 percent think requiring a government contractor to approve care will increase out-of-pocket costs.

• 76 percent trust health care professionals (primary care physicians and nurses) to handle issues related to health care.

• Just 6 percent trust the government with managing health care issues.

"When becoming educated on the topic of government approval of home health services, senior voters oppose policies that allow the government to interfere with physician decision-making," says Colin Roskey, executive vice president of the Partnership for Quality Home Healthcare. "Further, while CMS maintains that pre-claim review demonstration will reduce fraudulent Medicare claims in order to protect patients and the Medicare program, a majority of seniors did not agree that fraudulent claims will decrease as a result."

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Roskey says a better way to address concerns about fraudulent billing practices is to focus on improving oversight of the billing process rather than establishing another layer of bureaucracy to review physician behavior.

"We encourage collaboration between policy makers and health care stakeholders to develop policies that target fraud and abuse and streamline eligibility documentation standards for physicians and home health agencies" he says.