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The State of Health & Home Care for Seniors

July 01, 2015, 02:23 AM

With last month’s Supreme Court ruling that national subsidies in the Affordable Care Act are legal, more questions have been raised as to how the bill, aka “ObamaCare,” will continue to affect seniors. As a result of the changes from ObamaCare, the future of the home health industry has been a topic of debate among economists and healthcare industry insiders.

Changes in Medicare

One of the most contested aspects of the Affordable Care Act are the deep cuts in Medicare spending, totaling $716 billion by 2022. Of those cuts, $60 million has already been slated for home health payments this year alone. The decrease in spending is designed to lower the cost of prescriptions for the majority of seniors under Medicare Part D (seniors in higher income brackets, about 5% of total recipients, will pay more), increase the amount of preventative care in the form of annual well visits to plan a course of care, and more options for care after hospitalization. The “cuts” are technically “rebasements,” a step in reforming the Medicare system by reducing payments and reimbursements to healthcare providers in an effort to crackdown on wasteful spending and fraud while reallocating that money to recipients of Medicare programs.

How the Affordable Care Act Affects Home Care

Image Source (CC BY 2.0) by Will O'Neill via flickr

Image Source (CC BY 2.0) by Will O’Neill via flickr

Along with the reduction in payments to home health providers, the Affordable Care Act also enacted several other changes to the home care system designed to better the quality of care. In addition to changes and increased transparency for nursing homes, the ACA has introduced the Home Health Star Ratings system under the Centers for Medicare and Medicaid Services (CMS) as a way for seniors and their families to navigate Medicare-certified agencies based on quality of patient care metrics. The initiative operates on two ratings systems, Patient Survey Ratings, collected based on patients’ experiences as reported in Home Health Care CAHPS surveys, and Quality of Patient Care Star Ratings, based on patient assessments provided by the home care agency. Results of the survey are scheduled for release in January 2016, while Quality of Patient Care Star ratings are slated for publication shortly (mid-July); findings will be available on the Medicare Home Health Compare site.

In addition to the increase in accountability and transparency for home care providers, provisions in the Affordable Care Act have been enacted to provide services for a wider range of seniors. Beginning this year, physicians are no longer required to submit written narratives validating the need for in-home care services, an improvement agencies say will save on costs and allow more flexibility for seniors. The CMS also now requires therapy assessments every 30 days for Medicare home care patients, ensuring more focused care and assurances that that care is being effectively implemented.

What the Changes Mean for Care

The reduction of payments to home health care providers of 14% has worried many insiders and patients that the quality of care will decrease as well. But many feel just the opposite will happen. For patients paying out-of-pocket for home care, the result will be lower, more competitive pricing. For Medicare patients, the changes signal an emphasis on quality care over bloat and excessive provider reimbursements which can lead to fraud. Many home care agencies have prepared for these changes and cuts by streamlining staff and retraining caregivers and nursing professionals to provide more comprehensive care, under the watchful eye of government agencies on the lookout for fraud and abuse. Despite the worries that home care jobs may suffer as a result of cuts, in fact home health agencies increased hiring by adding over 8,400 jobs in May of 2015 alone.

If you or a loved one need or are interested in providing Chicago home health assistance, call Abcor today!

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