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.

 

 

 

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