Home Health Care For The Frail Elderly In Focus This Week

Home health care for frail, elderly patients is making headlines this week.  The Atlantic recently featured a piece on the economic benefits home-based primary care can offer to the US health care system going forward.

Focusing predominantly on Dr. Brad Stuart, the founder of Advanced Illness Management (AIM) at Sutter Health, the article takes a look at how treating frail, elderly patients with a comprehensive home-based plan can be more efficient and cost saving in many cases. The AIM program takes an overarching approach to patient care, managing patients’ chronic conditions with in-home visits and care coordination. Each patient is assigned a team of doctors, nurses, specialists, and more under the direction of a primary care physician. Patients remain in the AIM program for the duration of care, utilizing each individual resource as needed. This approach allows care to prevent hospital readmission, saving the patient and health care system time and resources. Earlier this year the Alliance held a webinar with Dr. Stuart and his colleague from the Coalition to Transform Advanced Care (C-TAC), Tom Koutsoumpas, on treating advanced illness, which touched on the AIM program. (Slides from their Innovation Perspectives webinar can be found here.)

Examples of successful home-based care stories in the article included those from MedStar Washington Hospital Center’s Medical House Call Program. One patient, a 92-year-old male had been in and out of the hospital before becoming a part of the MedStar program. The self-proclaimed hospital-hating patient has not been back to the hospital since joining the Medical House Call Program. We profiled the Practice Director for the Medical House Call Program, Dr. Stephanie Bruce, in September as part of our Innovation Perspectives Capitol Hill briefing on how health care delivery reforms are leveraging home health care. The full profile of these innovations at MedStar featuring Dr. Bruce can be found here, and a replay of the briefing can be found here.

Healthcare at home may offer a solution to the costs driving health care spending in the United States. As the article contends, with the Affordable Care Act penalties for hospitals with high rates of readmissions, many hospitals are less eager about readmitting Medicare patients. In addition, many Medicare demonstrations, pilots and programs have been created to pursue and explore innovative new models of care, offering home health care an opportunity to show its value in improving patient care and reducing overall cost of care. Sutter estimates in the article that the AIM program saves Medicare upwards of $2,000 per patient per month. Over time, the savings seen by including more comprehensive home-based care could be significant to providers and the health care system as a whole.

The article contends that the future is currently bright for home-based comprehensive care, as both the logistical and financial opportunities are there to see a push in the implementation of programs such as AIM and the Medical House Call Program. As part of our educational mission, the Alliance is proud to continue the discussion of affordable and high-quality home-based care with innovators such as Dr. Stuart and Dr. Bruce.



If you’re interested in learning more about the Alliance’s Innovation Perspectives series, click here for more information. Dr. Joanne Lynn, Director of the Altarum Institute’s Center for Elder Care and Advanced Illness, will be the next featured guest on our December 5th webinar at 2:30 pm ET. Dr. Lynn will speak on reforming care delivery to better support frail and elderly seniors who need both health care and long-term care. Click here for more information on next month’s webinar, and here to read Dr. Lynn’s recent opinion piece in the Journal of the American Medical Association.

From the desk of the Executive Director

As the landscape of health care continues to shift, now is the time to further the conversation on the role of home health in the future of health care delivery. New and emerging health care delivery system reforms focus on new ways to improve the quality of care delivered while lowering costs.  Home health care is being used in many of these emerging delivery system reforms.

Last week, the Journal of American Medical Association released a piece from Dr. Steven Landers, President & CEO of VNA Health Group and Chairman of the Alliance’s Board of Directors, on the increasing importance of home health care to Medicare patients (available here). Titled, “The Future of the Medicare Home Health program,” the article serves as a starting point for further conversations on the state of health care, and the ways in which home health care can provide a high-quality, lower-cost alternative for many patients.

Some of the key trends discussed in the piece include:

  1. An increasing patient desire to age at home
  2. A need for cost-effective solutions in the U.S. health care system
  3. The idea of home health care as a patient-preferred and high-quality alternative to other care.

Dr. Landers’ article offers perspective on the current state of health care, which should be addressed with regard to the present and future value of home health care in the Medicare program.

In our role to engage in and inform a directed conversation on the value of home health care, the Alliance is working to lead and support research and educational efforts to improve the U.S health care system. As part of our efforts, we are cultivating research on the value of home health care; educating policymakers, the public, and key stakeholders on home health’s role in a changing health care landscape; and working on solutions to improve home health through quality and innovation.

We are also encouraging our members to engage in the ongoing dialogues about how to foster solutions to improve health care in America in multiple venues—through our working groups; outreach to policymakers, patients, other health care providers, and key stakeholders through our social media channels; and through events such as Alliance webinars and congressional briefings.

“Beyond these suggested reforms, there also needs to be substantial national investments in education and research in home health care,” Dr. Landers concludes. “By revisiting the nation’s home health policy, there is an opportunity to improve quality, independence, and compassion for the largest group of older Americans in the nation’s history.”

Given the attention being paid to health care and the Medicare program in the context of the recurring budget battles in Washington, D.C., now is the time for home health to speak up as discussion and debate over the future of health care amplifies. We have a great opportunity to be leaders on a national stage and we invite our members to join us in educating the public on the value of home health care in the future.

Health News Round Up: Week of October 20 -26

Five Benefits of the Home Health Care Model
Hive Health Media
The term “health care” might bring to mind images of doctors and nurses in sterile clinics and hospitals. Thousands of people chose to remain at home to receive medical treatments such as rehabilitation services, respiratory therapy and home infusion therapy as well as unskilled home care services. Patients prefer this model because of the convenience and cost-effectiveness that it offers.Read more.


Home Care Industry Looks at Bundles, DGRs for Post-Acute Care
Inside Health Policy
The home health industry is looking at post-acute care reforms — including DRGs, pay bundles and lengthening home health episodes — following a report showing significant patient overlap among the types of facilities to which patients are discharged, an industry source said. But others are skeptical of using Diagnosis Related Group codes, which have been considered and dropped before as an option, and some industry and congressional sources said DRGs would incite fights among post-acute health care sectors.
Read more.


Hopkins Dementia Study Reveals Effects of Home Health Care
Bmore Media
A study conducted by Johns Hopkins University and a Jewish charity revealed that people with dementia could live in their homes with help 10 months longer than those without help. Read more.


Taking Care- November is National Home Care and Hospice Month
TC Palm
Is there a healthcare hero in your life? Each November home health and hospice agencies celebrate National Home Care and National Hospice Month to honor healthcare workers from a variety of disciplines, such as nurses, aides, clinicians, and therapists that have gone the extra mile and made a positive impact on the lives of those who are under their care. It takes a special person to work in the home healthcare and hospice field, and there is few, if any, more difficult or vulnerable times people will ever face in life than when in home care or hospice. Read more.


Appropriate Care Setting Protects Medicare’s Future
Roll Call
As our two presidential campaigns aggressively tout their domestic policy agendas, health care providers, stakeholders and patients are collectively holding their breath regarding a problem that, without dramatic intervention, is all but certain to occur: Under current law, the Medicare Trust Fund will be insolvent by 2024. Read more.


4 Discharge Tactics to Reduce Senior Readmissions
Healthcare Finance News
In light of the recent Readmissions Reduction Program under the Affordable Care Act, numerous hospitals and medical industry experts are examining new approaches that will decrease the rate of hospital readmissions.Read more.

Health News Round Up: Week of September 15-21

A Choice of Community Care, in Your Own Home
New York Times
For 51 years, Catherine Mack has lived in a four-bedroom house in Haddon Township, N.J. Even at age 96, she has no intention of leaving.
Joining other older adults at a nearby retirement community doesn’t appeal to her, although the facility is attractive and has a great reputation. Read more.


Transitional Care Improves Patient Outcomes
Fierce Healthcare
Adding to the growing body of evidence of the benefits of transitional care, a review of medical literature in the Annals of Internal Medicine found that some hospital-led interventions can improve outcomes for adult stroke and myocardial infarction patients. Read more.


Communication key to improving care transitions
Healthcare Finance News
A recently released health policy brief examining the efforts in the U.S. healthcare system to improve care transitions concludes that simple solutions would go a long way to improving patient care and saving costs.
Read more.


Worried about Medicare readmission penalties? Try Home Monitoring
Mobile Health News
Perhaps you’ve seen last month’s report from Kaiser Health News that more than 2,200 hospitals—almost two-thirds of all U.S. acute care facilities—face Medicare payment deductions starting Oct. 1 because too many patients with three common but treatable conditions were readmitted within 30 days of initial discharge. That’s going to cost those hospitals a total of $280 million during federal fiscal year 2013. Read more.


Top 5 fields for job growth heavy on healthcare, service
Springfield Sun News
Federal and state employment projections show that the most promising professions for jobs are in the service, retail and health care industries. Read more.


Health IT Solutions to Reduce Readmissions
Fierce Healthcare
In an effort to curb readmissions, hospitals should invest in health technology, including medical records, information sharing and telemonitoring, Jonathan H. Burroughs, president and CEO of The Burroughs Healthcare Consulting Network, wrote in Hospital Impact. Of the 5 million hospital readmissions in the United States, more than two-thirds are preventable, amounting to an annual cost of $25 billion, Burroughs wrote last week.Read more.

Health News Round Up: Week of August 25-31

Homecare is most cost-effective care for seniors
The Patriot News
Although some might not be familiar with homecare, it is important for people to recognize — particularly decision makers in Washington — how these services effectively address our seniors’ and disabled residents’ care needs. Read more.


Research Shows CMS Program Helps Seniors Transition to Home Care
Home Health Care News
In CMS’ effort to help nursing home residents move back into their homes and communities, 38% of successful transitions made from July 1 to Dec. 21, 2011 were patients over age 65, according to a Mathematica Policy Research progress report on the Money Follows the Person (MFP) program. Read more.


Virtual Visits Next Big Thing For Virginia Home Care
Home Health Care News
Sentara Home Care recipients in Virginia will gain access to 24/7, on-demand virtual health care consultations beginning in October, Sentara and its partnering company, MDLIVE announced last week. Read more.


As population ages, home health care grows
Dayton Daily News
Dayton home care companies are growing to meet the demands of an aging population that prefers to stay in their homes as long as possible, said local experts. Read more.


Hospitals Look to Home Care In Cutting Patient Readmissions
Home Health Care News
Medicare will begin penalizing 2,211 hospitals in October for having too many counts of patient readmissions, and some hospitals are looking to home health care as a solution to the readmission problem. Read more.


Riding the Wave of Home Health Technology
Billians Health Data
The next wave in healthcare is coming, and it has nothing to do with reimbursement, practice models or even new clinical strategies. Often referred to as “the Silver Tsunami,” it is the flood of Baby Boomers who require regular health services to manage their chronic conditions and maintain their independent lifestyles. Ten years ago, before the mainstream adoption of consumer-friendly technologies like smart phones, tablets and associated mobile apps, this demographic and their family caregivers most likely looked primarily to long-term care (LTC) facilities for assistance. Now that mobile health technology and new care protocols are evolving – and coming down in cost somewhat – the home health industry is beginning to play a greater part in keeping these older adults in their homes and out of often cost-prohibitive LTC facilities. Read more.


Home Health News Roundup: Week of August 11 – 17

Senior Care Technology the Antidote to Killer Side Effects of Loneliness from Aging in Place?

Senior Housing News

Loneliness comes with killer side effects for some aging-in-place seniors, but certain technologies geared toward social engagement may provide an antidote, senior care technology developers say.  Read more 

U.S. Should Make ‘Life-Long Homes’ A Priority, Says Henry Cisnerors

Kaiser Health News

What will it take for Americans to age successfully in place? This question has immediate importance for policymakers and families as an estimated 10,000 Baby Boomers turn 65 years old every day. It’s the subject of a new book, “Independent for Life: Homes and Neighborhoods for an Aging America,” authored by more than a dozen leading aging and housing experts and co-edited by Henry Cisneros, a four-term mayor of San Antonio and former secretary of the U.S. Department of Housing and Urban Development. Read more

U.S. News: 10 Things Aging Americans [Should] Want for a Better Retirement

Senior Housing News

Aging in place is a focal point of a list of ten improvements—which includes home-based healthcare, universal design, and more geriatricians—that aging Americans will want or eventually need as the older population continues its rapid expansion ,according to U.S. News: Money. Read more

CMS Adds Three More Healthcare Organizations to its Pilot Telemedicine Program

Health Tech Zone

Telemedicine is becoming so popular that even the government is doing it. Originally conceived as a way to monitor astronauts’ health in space, it’s now moved decidedly earthward and is bringing many benefits and rewards by caring for patients away from the hospital. Read more



FDA-Approval for Ingestible Sensors “Major Milestone”—Future of Home Health Care Monitoring?

Home Health Care News

The U.S. Food and Drug Administration (FDA) has approved an digital sensor that can be embedded in a pill and ingested to track health data from within the body, reports Medical News Today. Read more.

Sensors help seniors age at home

Healthcare IT News

A pilot program at University of Missouri shows promise with the use of sensor technology to help aging adults remain in their homes longer while being monitored by care providers. Read more.


Healthcare adds 12,000 jobs in July

Modern Healthcare

Healthcare employers added 12,000 jobs in July, the second straight month of slow employment gains in the industry as unemployment in the wider economy edged up slightly.Read more.


5-point strategy to reduce readmissions

Healthcare Finance News

The Centers for Medicare & Medicaid Services will penalize hospitals for readmissions beginning this autumn. As a result, many healthcare providers are taking a cold hard look at their bottom line in an effort to meet or exceed projected targets for the year. Read more.


5 ways health innovators are helping old people

MedCity News

Baby boomers may be graying, but the healthcare innovations that will serve them are cutting edge. Read more.


Survey finds seniors want to age in place

CQ Healthbeat

About 90 percent of seniors in a survey released Wednesday said that they hope to stay in their homes as they age. Within this group, about 85 percent said they believe they can do that without making major changes to their residence. Read more.


Home Health News Roundup: Week of July 14 – 20

Care Transitions Program Shows Home Health Care “Highly Effective” in Reducing Rehospitalizations

Home Healthcare News

A collaborative effort among hospitals, home health agencies, and a Medicaid-managed care program in upper New York has been successful in reducing hospital readmissions, according to a new report. Read more


Home Health Care Goes High-Tech

The Asbury Park Press

New technology is making it possible for more care to be administered from home. Read more


Home-Based Care Teams Offer Help for Patients With Dementia

U.S. News Health

New research suggests coordinated home healthcare efforts for patients with dementia can improve quality of life and delay the need for nursing home care. Read more


Home Monitoring Device Market Surge to Keep Seniors at Home 

Home Healthcare News

The market for in-home health monitoring services is expected to grow from fewer than 3 million to more than 36 million units over the next five years, according to forecasts from ABI Research. Read more


Hospitals’ readmission rates still too high, government says

The Washington Post

Despite government efforts and the threat of financial penalties, hospitals are making little headway in reducing the frequency at which patients are readmitted. Read more


HHS: Health law project will cut state costs in major programs

The Hill’s Healthwatch

HHS Secretary Kathleen Sebelius says a new project under the Affordable Care Act will improve care and cut spending in the Medicaid and Medicare programs. Read more

Home Health News Roundup: Week of July 2 – July 6

Nursing home costs grow as home health costs stay flat, survey shows

A new study by Genworth focused on the change in elder care costs in 2011. While nursing facilities saw costs increase between 1.2 and 4.2 percent, home health costs saw no increase at all.


New Numbers on Elder Care

With the addition of elder care to the American Time Use Survey, the Bureau of Labor Statistics can now identify the segment of the population providing care to the elderly, as well as the types and frequency of care provided.


Study: Frequent Hospice Visits Can Help People Remain Home at End of Life

According to a new report highlighting the importance of hospice programs, patients who prefer to remain home at end of life are more likely to be able to do so if they get frequent visits from nurses and doctors.


New elderly care program controls health costs

A new type of elderly care program is saving money by allowing patients to live at home while receiving care and company at a day care center.


Use of electronic health records by post-acute providers improves care transitions, experts say

Experts believe the use of electronic health records by post-acute care providers can improve and ease transitions for patients during the recovery process.


CMS Wants to Cut Home Health Agency Payments by $20 Million in 2013

On Friday the Centers for Medicare and Medicaid Services (CMS) announced the new home health prospective payment system (HH PPS) rule to cut payment rates to home health agencies by $20 million in 2013. The proposed rule is expected to encourage efficiency and payment accuracy among providers.