Case Management Society of America

Features

The Many Options for Care in the Home

BY MARY MCLAUGHLIN-DAVIS, DNP, ACNS-BC, NEA-BC, CCM

In 2014, about 3.4 million Medicare beneficiaries received home care, and Medicare spent about $17.7 billion on home healthcare services. More than 12,400 agencies participated in the home care program in 2014. Over 99 percent of beneficiaries live in a zip code where Medicare Home Health Agencies operate, and 82 percent of beneficiaries live in a zip code with five or more Medicare Home Health Agencies. Medicare Home Health Services consist of skilled nursing, physical therapy, occupational therapy, speech therapy, aid services and medical social work (Medpac.gov, 2016).

With the advent of advancing the triple aim — improving the patient experience of care, reducing the per capita cost of health care and improving the health of populations — home healthcare is an important aspect of the emerging population health models.

Many of our patients are receiving care at home today, which in the past may have been reserved for an acute hospital step-down unit or even an intensive care unit. Skilled home respiratory services assist patients to return home with oxygen, but they also assist ventilator-dependent patients to return and remain home. It is now possible for our patients to return home earlier from an acute care hospital or a skilled nursing facility than in the recent past.

Medicare Home Health Care is accessible, comprehensive and less expensive than an acute care hospital. Our patients and our families generally prefer to be in their own home, as opposed to a hospital.

Skilled home healthcare is one aspect of the many services that are available in the home. There are many other non-skilled services patients can use. These include, but are not limited to, home health aides, home companions and home case management.

Durable medical equipment providers can move specialized wheel chairs, beds, mattresses, respiratory equipment and necessary hospital equipment such as bedside tables into the home.

It is incumbent on today’s case managers to familiarize themselves with the many options for care in the home. It is our duty to assist patients to experience the highest quality of life in the safest and most cost-efficient manner possible. In fact, we now have many case managers working in home care and coordinating care from that vantage point.

I hope you enjoy our home care issue. We know if something seems impossible for a patient, a case manager will make
it happen.

Reference

Medpac.gov. 2016. http://www.medpac.gov/docs/default-source/reports/chapter-8-home-health-care-services-march-2016-report-.pdf?sfvrsn=0

Mary McLaughlin-Davis, DNP, ACNS-BC, NEA-BC, CCM

President, CMSA 2016-2018

Dr. McLaughlin-Davis is the president of CMSA. She has been a certified case manager since 1993; she is a clinical nurse specialist for adult health and the senior director for care management for Cleveland Clinic, Avon Hospital.