The coronavirus pandemic has ushered in many changes including remote work, ZOOM meetings, and online schooling, among others. It’s also shifting the way Americans look at elder care as the pandemic has devastated nursing homes and other long-term care facilities. Now the benefit of turning to home health care is in the spotlight.
To date, more than 115,000 individuals linked to long-term care facilities have died from COVID-19 while patients remain isolated and lonely as they are kept from seeing loved ones and friends because of the virus. As a result, families and the healthcare community are rethinking the entire senior-care paradigm. According to a recent article in the Wall Street Journal (WSJ), occupancy in U.S. nursing homes is down by 15%, or more than 195,000 residents, since the end of 2019, driven both by deaths and by the fall in admissions. Federal data analyzed by the WSJ shows that the decline in nursing-home patients covered by Medicare, which provides payments vital to the homes’ business model, is even steeper. It’s important to also note that nursing-home use in the U.S. has been declining gradually for years. In 2019, occupancy was 80%, down from 84% a decade earlier, according to the Kaiser Family Foundation.
Changes in Medicare, Rise in Telemedicine Utilization Contribute to Home Health Care Option
During the height of the pandemic earlier this year, hospitals treating nursing home patients were sending them home to recoup – now potentially spurring even greater adoption of this practice by physicians, hospital systems and insurers. In the WSJ article, Peter Pronovost, chief clinical transformation officer at University Hospitals, an Ohio-based system, was quoted as saying, “We implemented a complete switch of mind-set to say home is the default for patients leaving the hospital, even frail ones…I don’t think we’re ever going to go back. The drive to get every patient home who can be home is going to continue.”
Making home health care more of an option for many patients is a result of regulatory changes which allow Medicare to pay for digital doctor visits and intense, hospital-level care in patients’ homes. Medicare has also begun rewarding health-care providers for lowering overall costs, giving providers an incentive to reduce referrals to nursing homes. In addition, the Trump administration amid the pandemic has given Medicare insurers more flexibility to spend money on things that improve patients’ home setups. During his campaign, President-elect Joe Biden also promised to spend $450 billion to make sure people who need long-term care can get support in the home and community.
Major Medicare-plan providers Humana Inc. and UnitedHealth Group Inc., according to the WSJ article, say programs that would allow sicker patients to be discharged from hospitals to their homes are under development. The shift in nursing-home use “is probably one of the trends coming out of COVID, along with telemedicine, that is going to act as a real accelerant and be sustainable,” said Susan Diamond, who leads the home business of Humana.
Indeed, surveys have indicated that patients prefer to rehabilitate or age in place at home. “We should be able to provide more services in the home setting that can enable somebody to be independent,” said Seema Verma, administrator of the Centers for Medicare and Medicaid Services. “COVID is going to force a national conversation about how we take care of our elderly, and clearly there are issues in nursing homes that go beyond infection control,” she said.
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Source: Wall Street Journal