Inaugural #HomeHealthChat: Cost-Effective Home Health Care

On Tuesday, July 23rd, the Alliance hosted its inaugural #homehealthchat on Twitter. The Twitter chat focused on the cost-effectiveness of skilled home health care and featured the Partnership for Quality Home Healthcare (@PQHH) as the Alliance’s co-host.

The hour-long conversation covered topics ranging from the benefits of coordinated care to the consequences of reinstituting a copayment on home health care episodes. Chat attendees discussed and provided examples of home health care as a cost-saving and patient preferred alternative to other forms of post-acute care.

The following questions were posed during the chat:

Q1: What makes home healthcare a cost-effective alternative to other settings?
Q2: Who benefits most from cost-effective home healthcare?
Q3: How would a co-pay affect patients who want to receive care at home?
Q4: What types of clinical and medical care can home health professionals offer patients with their homes?
Q5: What role can coordinated care play in improving the patient experience and quality of care?

The Alliance will host future home health-focused Twitter chats on the fourth Tuesday of every month at 2pm ET. Be sure to check here for updates on topics and questions! If you have topic ideas for future Twitter chats, or are interested in co-hosting a chat, please email C. Grace Whiting, the Alliance’s Director of Strategic Initiatives & Communications, at

Below are some of the highlights from the first chat:

VA Home Based Primary Care

The American Action Forum recently released a paper entitled, “VA Home Based Primary Care Program: A Primer and Lessons for Medicare.” The primer highlights the Department of Veterans Affairs (VA) Home Based Primary Care (HBPC) and how Medicare can take notes from a long-standing and highly successful program in home healthcare.

 Brief background on the HBPC program

  • Program began in 1972 with 6 demonstration sites
  • Serves veterans with chronic and disabling conditions who need more care than periodic doctor visits
  • Veterans have a care team consisting of physician medical directors, nurses, social workers, dietitians, psychologists, pharmacists and rehabilitative therapists who provide integrated and coordinated care for the patient
  •  No requirement that a patient be “homebound” or require skilled rehabilitative care

 What has the HBPC program accomplished?

  • Participants in the HBPC program saw a drop in hospital days by 62 percent
  • Nursing home care days dropped by 88 percent
  • Overall healthcare costs were reduced by 24 percent
  • A study concluded that participants in the HBPC program had higher scores for “health related quality of life” when compared with a control group

Medicare’s home health benefit serves nearly 3.5 million Americans, but differs drastically from the VA’s HBPC program on several key points, including providing care to patients who are homebound as opposed to a larger population of chronically ill patients. Medicare home health visits center around 60 day episodes whereas HBPC provides care to a patient for any amount of time as long as it’s appropriate. HBPC also focuses on coordination between a team of healthcare providers whereas Medicare home health is mostly medical, and often rehabilitative, in nature.

Furthermore, the Clinically Appropriate and Cost-Effective Placement (CACEP) report, recently released by the Alliance for Home Health Quality and Innovation details how placing patients in the most clinically appropriate setting achieves huge savings in the Medicare program. Home healthcare is often the most appropriate setting and significantly reduces hospital admission and readmission rates. Improving the Medicare home health benefit would only add to these already impressive statistics.

Bottom Line

Policy makers should look to the HBPC model to improve the Medicare home health care benefit due to successful outcomes and patient satisfaction, care coordination and significant cost savings.

New Data on Hospital Readmissions: CACEP Working Paper #4

The Alliance today released Working Paper #4 of the Clinically Advanced and Cost-Effective Placement (CACEP) research project, which examines hospital readmission and admission frequency and associated Medicare episode payments across three episode types: post-acute, pre-acute, and non-post-acute (community-based) care. Hospital readmissions and admissions were analyzed within the context of patients’ chronic conditions and demographic characteristics.

Key Findings

  • Hospital readmissions increased Medicare episode payments by at least 100 percent.
  • Patients with more severe primary chronic conditions tend to have more readmissions.
  • 22.4% of post-acute care episodes have at least one readmission.
  • Medicare post-acute care payments more than double when an episode contains at least one readmission, from an average payment of $15,335 without a readmission to $33,926 with a readmission.

Additional Working Paper #4 Resources

Full Report 
Study Highlights
Executive Summary
Presentation Slides

Home Health Implications

CACEP Working Paper #4 data suggest that better management of chronic disease across all three episode types through home health intervention could enable more patients to remain out of the hospital following an initial admission, or prevent avoidable hospitalizations all together.  Clinically appropriate and cost effective care ultimately can improve the quality of patient care and reduce the cost for the Medicare program and taxpayers.  Home health care combines the right mix of care management, prevention training and close observation to significantly reduce hospital admissions.

As lawmakers look into ways to reduce spending from hospital admissions and readmissions, how can home health be part of the conversation? Please comment below to submit your ideas. 

Stay tuned for the release of the final paper of the Clinically Advanced and Cost-Effective Placement (CACEP) project this fall. Details coming soon!

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