The Choose Home Care Act of 2021, introduced in both the U.S. House of Representatives and the Senate last year, would enable eligible Medicare patients to receive extended care services as an add-on to the existing Medicare Home Health benefit for 30 days post discharge from the hospital. Choose Home would help seriously ill individuals recover safely at home.
Pandemic Underscored the Benefits of Home Care
Home care has long proven to be a safe and effective alternative to care in an institutional setting,
enabling millions of Medicare beneficiaries who have suffered serious injury or illness to recover in the comfort of their own homes. The value of home health care became even clearer during the pandemic, as it helped many seniors avoid riskier institutional settings, such as skilled nursing facilities (SNFs), assisted them in remaining independent, and reduced the burden on overpopulated hospitals.
Unfortunately, not all seniors have the option of receiving home health care after being discharged from the hospital. Many people must seek post-acute care in an SNF rather than being able to choose their own care preference. Seniors on Medicare are often automatically transferred to an institutional setting under the program’s current post-hospital care system. While institutional settings are important for patients, they do not always meet all of their unique preferences or circumstances. As the pandemic demonstrated, home health care is an appropriate choice for many patients because it allows them to return home safely while avoiding some of the inherent risks of communal living, such as contracting COVID-19 or other infectious diseases that can cause significant harm to older patients.
In addition, according to the National Association for Home Care & Hospice (NAHC), about 33% of patients who go to SNFs “have identical frailty scores to those who receive care at home.” The principal difference is these patients lack access to extended caregiver services and other supplemental health care support.
NAHC and PQHH Support Choose Home
To date, the Choose Home Act has not been passed, although it does have bipartisan support. The NAHC along with the Partnership for Quality Home Healthcare (PQHH) advocate for passage of the Choose Home legislation, as it would provide a cost-effective home-based extended care benefit for Medicare patients leaving the hospital. Patients would receive a mix of expanded skilled nursing, therapy, personal care (up to 360 hours as needed), telehealth services, non-emergency transportation, clinically appropriate meals, home adaptive equipment, medication management, other benefits.
Patient eligibility for the Choose Home option would be controlled via an assessment tool that takes into consideration an individual’s place of care preferences, functionality, medical conditions, goals regarding care, and family caregiver concerns. Eligible patients would be referred to a home-based extended care qualified home health agency that offers the Choose Home benefit.
The Choose Home Act is projected to generate Medicare savings of $144 million to $247 million annually, with $1.6 billion to $2.8 billion in savings over 10 years, according to independent health economics firm Dobson DaVanzo.
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Sources: NAHC, Boston Herald