Home Health: Has the Time Come?

The health care industry has been trying to contain expenses through technology offering medical services to people at home. Some insurance plans offer a 24-hour nurse line, allowing you to call a nurse for advice in the middle of the night about a child’s high fever rather than rush to the emergency room. Some providers promote telemedicine for chronic care patients, using a quick video conference to update patient information and allow for a cursory visual exam.

This growing trend has accelerated in light of the coronavirus, which may well be a silver lining. In recent months, virtual care has skyrocketed in use as consumers quickly adopt technology-enabled physician visits as a safer option. Before the pandemic, an average 13,000 Medicare beneficiaries received telemedicine in the span of a week. By the end of April 2020, nearly 1.7 million a week engaged in telemedicine calls.1 On average, a telemedicine call costs $79 versus $146 for a doctor’s office visit.2

This has been particularly key for elderly patients who tend to need more health care but are also more vulnerable to the devastating effects of COVID-19. In fact, seniors who receive in-home assisted living have avoided the rampant contagion that has been occurring in nursing homes.3 To further assist the at-home elderly, the Centers for Medicare & Medicaid Services proposed a rule in June that would permanently allow reimbursement of administrative expenses for home-health agencies registered with Medicare. Today, about 6 million older Americans receive some form of home-health care, such as skilled nursing, physical therapy, speech-language pathology, occupational therapy, home health aides and medical social services. The Trump Administration is also recommending upping payment rates for home-health providers by 2.6% starting in 2021.4

The reality is that people are living well into old age and most people in their late 80s and 90s do need in-home care assistance, whether medical or otherwise. It is very expensive. If you would like to explore ways to help leverage your retirement assets in the event you need to pay for in-home care during your later years, please contact us.

Home-health care is now advancing to a point that addresses one of the elderly’s greatest fears: hospital visits. Because some older people end up dying while in the hospital, it is often associated with dying rather than healing. Unfortunately, it’s true that many older people risk contracting infections and other debilitating effects as a result of entering the hospital for an unrelated ailment. This is particularly true for patients who are frail, cognitively impaired or have other vulnerabilities.5

This reality has prompted Medicare to allow hospital providers to be reimbursed for acute care services delivered in surgery centers, hotels or other non-hospital facilities. The Veterans Health Administration has even funded its own hospital-at-home program. For example, a physician assistant or nurse practitioner may be able to administer lab tests, X-rays and other treatments in the home of a patient, whereas an emergency medicine physician can make diagnosis and treatment decisions via virtual consultation.6

Content prepared by Kara Stefan Communications.

1 Mia Jasper. NextGov. July 17, 2020. “Early data shows patients quickly embraced telemedicine options agencies expanded during the coronavirus pandemic.” https://www.nextgov.com/it-modernization/2020/07/lawmakers-push-make-telehealth-options-permanent/166965/. Accessed July 17, 2020.

2 Himanshu Kansal. Highpoint. July 14, 2019. “Telemedicine: The cost effective future of healthcare.” https://www.highpointsolutions.com/telemedicine-cost-effective-future-healthcare/. Accessed July 15, 2020.

3 Bailey Bryant. Home Health Care News. July 14, 2020. “UnityPoint Health Developing New SNF-at-Home Model, Seeking Home Care Partner.” https://homehealthcarenews.com/2020/07/unitypoint-health-seeks-home-care-partner-for-new-snf-at-home-model%EF%BB%BF/. Accessed July 15, 2020.

4 Rebecca Pifer. HealthCareDive. June 26, 2020. “CMS wants to make home health telemedicine permanent.”

https://www.healthcaredive.com/news/cms-wants-to-make-home-health-telemedicine-permanent/580615/. Accessed July 15, 2020.

5 Martha Hostetter and Sarah Klein. The Commonwealth Fund. July 7, 2020. “Has the Time Finally Come for Hospital at Home?” https://www.commonwealthfund.org/publications/newsletter-article/2020/jul/has-time-finally-come-hospital-home. Accessed July 15, 2020.

6 Ibid.

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