Medicare spending for home health care dropped 45% from Federal fiscal year (FY) 1997 to FY 1999, according to the Congressional Budget Office's (CBO's) April 2000 and April 1999 reports, which analyze the President's budgetary proposals for FY 2000 and FY 2001. In the most recent analysis of the President's proposals for FY 2001, the CBO identified a 12.5% drop in Medicare spending for skilled nursing facility (SNF) services and a 34.9% drop in Medicare spending for home health services in 1999. The CBO attributed the declines to the new payment systems established in the Balanced Budget Act of 1997 (BBA). The CBO indicated that increases in the time to process claims accounted for an average of 3.9 percentage points of the drop in SNF payments and 1.5 percentage points in home health payments. According to the CBO estimates, which take into account changes in Medicare SNF and home health payments adopted as part of the Balanced Budget Refinement Act of 1999, post-acute care payments are projected to increase at an average annual rate of 7% for SNF services and 12% for home health services from FY 2000 through FY 2010. GNYHA believes that the CBO data confirm that the BBA made excessive cuts in payments to SNFs and home health agencies, and support GNYHA's efforts to secure additional post-acute care relief at the Federal level.