Home Health is Where the Heart is

This February, in celebration of American Heart Month, don’t overlook the importance of the home as a critical place of care for those with heart conditions.

A quick look at the most recent year available shows that heart failure, hypertension, and other heart conditions are common among the home health care population.

  • Heart failure and shock (with and without major complication or comorbidity) are the third and fourth most common MS-DRGs for home health Medicare Part A episodes
  • Heart failure is the fifth most common diagnosis (using ICD-9 codes) among all Medicare Home Health claims.
  • Ninety-eight percent of the time on average nationally, home health teams met the quality measure for treating heart failure symptoms.

Nationally, hypertension is the most common chronic condition among Medicare beneficiaries with 27.5 million beneficiaries aged 65+ diagnosed. Other heart conditions, which include coronary artery disease, peripheral vascular disease, and peripheral artery disease, is third, and congestive heart failure is 12th, in front of mental illness/disorder, Alzheimer’s Disease, and broken hips.

The Home Health Quality Improvement (HHQI) National Campaign sheds further light on the common symptoms on a heart attack, as well as some of the risk factors for heart attack and heart disease in a recent blog post.

Given both the preference to age in place and the lower cost to the system home health care affords, more and more Boomers will be receiving home health care in the future. And it turns out, the home can be a critical care provider for many suffering from various heart conditions.

A few years ago, the Alliance did a series of profiles on utilizing new programs and technology to reduce readmissions, all with a focus on heart failure patients. These case studies showed a decrease in rehospitalization rates for heart failure patients using an array of telehealth programs. Interventions in the programs included patient education on how the heart works, care transitions from hospital to home, and telemonitoring measurements.

For instance, in 2007 the Visiting Nursing Association of Western New York began a hospital to home program in conjunction with what was then Cardiocom (now Medtronic Care Management), which utilized telehealth data to track patient progress and identify a need for possible early intervention. The program was instituted for cardiac patients including those with heart failure, hypertension, post coronary artery bypass graft surgery, atrial fibrillation, coronary atherosclerosis, and chronic obstructive pulmonary disorder (COPD). Typically, patients would digitally check-in with weight and blood pressure measurements, as well as a few health-related questions. A telehealth team would receive the information almost instantaneously, and would review whether a patient was following their prescribed medical regime. If the team spotted an issue, they worked with the patient’s physician to make adjustments. During the course of the program, the Visiting Nursing Association of Western New York saw an 11 percent decrease in acute care hospitalizations and high patient satisfaction ratings.

Programs such at the one implemented by VNA of WNY demonstrate one way in which home health can be a vital resource for those with an array of heart conditions. Working hand-in-hand, technology and home health are poised to continue serving many more happy hearts in the future.