The writer, of Omaha, is president & CEO of Visiting Nurse Association (VNA), an organization that offers a wide range of in-home and community-based services to individuals of all ages and stages of life. He is past chair of the Visiting Nurse Associations of America.
On Jan. 1, 2020, changes took effect that adjusted how Medicare therapy reimbursements are managed for home health care. While eligibility criteria for Medicare and home health services remain unchanged, the primary impact is related to how providers get paid.
Changes were made to move Medicare payments toward a structure that holds providers accountable for patient outcomes and costs. This new level of accountability was necessary because some home health care agencies were basing patient care on the best possible reimbursement for their agency instead of the best possible outcome for the patient — a practice which I, as an industry professional, find completely unacceptable.
Since new parameters for Medicare reimbursement have been in effect, media outlets have reported incidents of Medicare patients finding it more difficult to get home health care, while others have experienced reductions to in-home therapy. These unacceptable practices are the antithesis of quality patient care and amplify a systemic abuse of the Medicare reimbursement system.
In contrast, Visiting Nurse Association’s patients will see little to no change in the home health care services they currently receive.
By putting patients’ needs first and defining the highest standard of home health care and healing, we are modeling best practices for our field and taking positive steps in the right direction for our country’s health care system.
In the United States, more than 3 million rehospitalizations occur each year. A 2019 study published in the Journal of American Medical Directors found that one to two weekly physical therapy sessions can help lower home health patients’ chances of ending up back in the hospital by up to 82% in a 60-day period. These are the practices to which VNA and other patient-focused organizations adhere, while media outlets report other local agencies have reduced their physical therapy workforce and reduced this benefit to patients.
If you or a loved one are considering home health care, one of the most important questions to ask is if you will have a say in the care you or the one you love receives. The provider you choose should not reduce care in any way based on reimbursement.
The best approach, like the one we take at VNA, is to collaborate with patients to understand their needs and desires. Together with the home health care agency, the patient and caregiver should design plans of care that are consistent with the patient’s goals and with what their doctor recommends they need for better health.
The care patients receive at home is critical to their healing and recovery. Home health care provides a safe and affordable solution that supports the patient and the entire family, allowing them to stay in the comfort of their own home. Having professional and experienced home health care has proven to be more effective in easing the transition from hospital to home, reducing rehospitalization rates, delivering better overall outcomes and supporting a healthier population.
Everyone deserves the best care and kindness and to feel better at home. Patients need health care professionals who are committed to providing them with personalized care to help them live healthy, safe and independent lives. As our health care evolves and as our community grows and changes, the home health care industry will be looked upon to provide innovative leadership and thoughtful solutions. That’s how VNA will continue to shape tomorrow’s care.
U.S. Rep. David Cicilline (D-R.I.) is sponsoring a resolution to once again amplify aging-related issues through the Permanent Select Committee on Aging. The committee would aim to better address various issues that affect seniors, such as housing, long-term care and poverty, among others.
A lot of the panel’s focus on its first near 20-year run was on long-term care. That means its second go-around would likely be a positive development for the home-based care industry, especially if committee members become further aware of the solutions that can be found through home-based care.
Cicilline’s resolution — H.Res 821 — proposes reinstating the panel, which was active from 1974 to 1993, but later squeezed out in an effort to save money. This is the third time Cicilline has tried to bring the committee back, but his chances are better now because his fellow Democrats are in control of the house.
“Our nation’s seniors deserve dedicated attention by lawmakers to consider the legislative priorities that affect them, including Social Security and Medicare, the rising cost of prescription drugs, poverty, housing issues, long-term care and other important issues,” Cicilline said in a statement.
If the congressman’s resolution is ultimately passed, the committee itself wouldn’t have any legislative jurisdiction. Instead, it will be authorized to conduct a continuing and comprehensive review of the slew of issues that could affect seniors as the aging population rapidly increases in the United States.
The population changes will affect more than just the aging population, which furthers the justification for such a panel to exist, National Association for Home Care & Hospice (NAHC) President William A. Dombi told Home Health Care News.
“When you look at the demographics and the various government programs spending on services and support for people who are aged, these are clearly presenting high-priority policy, business and social issues,” Dombi said. “And that affects not only those direct individuals who would fit into the category of aged, but also everybody else. We really need national attention more today than ever before on those issues.”
That was the committee’s role in the past as well — directing national, broad-scope attention to issues affecting seniors.
The return of the Permanent Selection Committee, some think, is long overdue.
That concept of reviewing and studying relevant and forthcoming challenges for the older demographic will be of obvious help to a country with a population that will skew much older in the next 20 years.
“Medicare, Medicaid, VA services on the health care side — those tend to dominate [attention],” Dombi said. “But you can go beyond that into the population health aspects of things: housing, transportation, dealing with loneliness.”
When more attention is paid to aging issues in general, that attention can be spread out to a wider variety of issues.
“We’ve got to really heighten the national priority in focusing on the elderly,” Dombi said.
Earlier this month, Dombi himself worked to establish that national priority for home health care during a special hearing in front of the U.S. Senate’s Special Committee on Aging. The group of home care industry members that Dombi was a part of discussed allowing non-physician practitioners to certify a patient’s eligibility for some health coverage and the home health rural add-on, among other things.
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Home Care Workers Urge Presidential Candidates to Address Caregiver Crisis, Raise Wages.
With less than nine months before the 2020 U.S. presidential election, home care workers in early primary states are urging remaining presidential candidates to address the ongoing caregiver crisis and raise wages.
Nationally, the demand for caregivers continues to grow, as an estimated 10,000 adults turn 65 every day. And while home care is one of the fastest-growing fields, low wages and insufficient benefits have contributed to a worsening workforce shortage and historically high turnover rates.
Stagnant reimbursement rates have also contributed to the crisis, leaving in-home care providers handcuffed when it comes to competitively compensating caregivers and competing with a more lucrative retail sector.
As a response to the caregiver crisis, workers are calling for solutions that provide both affordable home care for seniors and livable working conditions for home care workers, including a $15 an hour minimum wage.
“It’s time presidential candidates address this crisis,” Mary Franklin, a Las Vegas caregiver, said in a statement. “Our working conditions don’t reflect the value of what we do. It took me 12 years to get a $2 raise to $12 an hour. I can’t afford to get sick, I have no time off or mileage pay when I drive from client to client — and that alone costs me at least $60 a week on gas. I feel underpaid and overworked.”
One U.S. lawmaker — Senator Bob Casey (D-Pa.) — recently introduced a bill that aims to help providers raise wages for their caregivers.
And so far, a number of the Democrat presidential hopefuls have addressed widespread senior long-term care needs to various degrees.
In November, South Bend, Indiana, Mayor Pete Buttigieg announced his plans to provide older adults access to long-term care, including in-home care. Buttigieg released a set of policy proposals that would set up Long-Term Care America, a benefit program that would provide seniors $90 a day to cover long-term care costs.
The daily median cost of homemaker services in 2019 was $141, according to the Genworth Cost of Care Survey. For home health aide services, the daily median cost was $144.
Both Senators Bernie Sanders (D-Vt.) and Elizabeth Warren (D-Mass.) have proposed that long-term care would be covered under Medicare for All. Additionally, Sanders took to Twitter last August to argue his stance that all older adults have access to affordable long-term care options as they age.
“No senior should have to sell their belongings or spend their life savings just to be able to age in place,” Sanders said. “Under Medicare for All, long-term, home-based care will be guaranteed as a right to every senior and person with a disability in America.”
In July, Senator Amy Klobuchar (D-Minn.) announced her plans for senior care. Klobuchar’s plan would provide a refundable tax credit to balance the cost of long-term care. Her proposal also aims to lower the cost of prescription drugs for those suffering from Alzheimer’s disease.
Although he is no longer in the running, Senator Cory Booker, a New Jersey Democrat, was among the first presidential candidates to outline long-term care and caregiving funding plans.
“We have a system now that’s just unfair,” Booker said in July 2019 during an AARP event. “It forces you to impoverish yourself in order to qualify for a lot of the Medicaid benefits. That to me is just unacceptable.”
By 2030, people over the age of 65 will reach 20% of the U.S. population, outnumbering children for the first time in the country’s history. That trend is particularly evident in early primary states, such as Nevada, South Carolina and others.
“Most home care workers are women, and women of color like myself and my mother before me,” Kim Thomas, a home care and hospice worker in South Carolina, said in a statement. “Our jobs have been historically dismissed as ‘women’s work.’ For the sake of our seniors, we need to transform home care from a low-wage, dead-end job into a sustainable career.”
Thomas and Franklin made their comments through the Service Employees International Union (SEIU).
***Source: Home Health Care News | Written by Joyce Famakinwa | February 18, 2020.
M&Y Care have been in business for over 20 years and possess the necessary experience to help guide you through the home care decision making process.
Home care is supportive care provided in the home by licensed healthcare professionals who provide medical treatment needs or by professional caregivers who provide daily living assistance for a loved one. Caregiver duties are wide-ranging. One moment a caregiver may be shopping for meals or cleaning the carpet and the next they could be discussing medication dosage with the pharmacist or arranging transportation for a specialist appointment. The caregiver is responsible for ensuring continuity of care to the loved one, whatever that entails.
We understand the challenges of a family to manage and care for a loved one’s needs during their recovery period or throughout the “aging in place” process. We also understand how difficult it is to allow someone to come into your home or a family member’s home. M&Y Care has served thousands of families and has dealt with many different situations, schedules, personalities, and needs. We understand that this is a new process you will be going through and we take the time to answer all your questions.
Although most home care requests are usually planned, M&Y Care can assist families who require a faster response in emergency situations such as a late day discharge from a hospital or rehabilitation facility. We are also available to help with requests for in hospital aid, assisted living facility bedside care, or major transitions such as assisted living to a family member’s home.
Whatever your need, M&Y Care is ready to help. Contact us to learn more about how M&Y Care can create an affordable personalized care plan for you.
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