Home Health ServicesOur medical billing and coding company often helps physicians report home visits. Home health care is less costly, more convenient, and just as effective as care provided in a hospital or skilled nursing facility (SNF). Recent reports indicate that the demand for home health services among the elderly is on the rise.

According to the Census Bureau, people born between 1946 and 1964 – known as baby boomers – now make up 22.9 percent of the U.S. population. Mobile health devices and telehealth platforms are two recent approaches to health management designed to meet the needs of seniors and improve social and clinical outcomes at senior living facilities and long-term care facilities. With home health services, seniors can stay at home instead of in a hospital or a skilled nursing facility.

Most seniors prefer to age in place. And with the addition of comprehensive in-home support, they can do just that. A recent CNBC report notes that Medicare home healthcare services are allowing seniors to maintain their health and independence, while also getting the assistance they need. Dr. Steven Strongwater, president and CEO of Massachusetts-based ACO Atrius Health, told CNBC that he believes that health-care generally will continue to move from the hospital to the home over time.

Home health care services for Medicare beneficiaries

Home health care for Medicare beneficiaries covers a wide range of health care services that can be given in the individual’s home for an illness or injury. Based on their Medicare health plan, home health services that people receive would include:

  • Wound care for pressure sores or a surgical wound
  • Patient and caregiver education
  • Intravenous or nutrition therapy
  • Injections
  • Monitoring serious illness and unstable health status

Besides registered nurse visits, there are Medicare plans that include social support and services of a trained home aide to help with daily chores such as cooking and cleaning.

Accountable Care Organizations delivering affordable, more convenient care

Efforts to improve health care efficiency, reduce hospital readmissions, and lower costs have changed the way hospitals deliver health care.

Improvement in home-based care comes as patients increasingly seek cheaper and more convenient care. In addition to mHealth, new systems such as the Accountable Care Organizations (ACOs) are facilitating home care. An ACO is a network of physicians and hospitals that shares financial and medical responsibility for providing coordinated medical care for patients from the physician’s office to home care with the aim of limiting unnecessary spending.

Under the ACO models established by the Centers for Medicare & Medicaid Services (CMS) and commercial payers, physicians’ practices and hospitals are working together in an effort to deliver well-coordinated, high-quality care and reduce costs. Providers who successfully lower costs and improve outcomes for the patients they serve are eligible for bonuses.

Benefits of home health care

By treating an illness or injury successfully, home health care helps patients get better, regain their independence, stand on their own feet, maintain their current condition or level of function, and slow decline. Other benefits of home health care include:

  • High quality care that is more affordable care as compared to nursing homes
  • Less risks of infection as opposed to a nursing facility or hospital
  • Rehabilitation following hospital stay in the comfort of their own home promotes quicker healing
  • Allows for personalized, one to one care
  • Physiological and emotional benefits from familial support
  • Improved quality of life due to regular visits from the hospital

The CNBC report noted that a recent Commonwealth Fund survey found that the percentage of home-health patients whose showed improvement in mobility, an important measure of quality of care, rose in every state from 2013 to 2016. The study found that hospital readmission rates for elderly Medicare beneficiaries also fell continuously in nearly half the states from 2012 to 2015.

Positive trends

The future of home-based care is positive as the number of ACOs continues to increase across the country. With large hospitals providing more outpatient services or online consultation services, hospital admissions in the US have declined. According to CMS, 561 ACOs are participating in Medicare Shared Savings Program in May 2018, up from 480 in 2017 and 433 in 2016. ACOs are also focused on continuing to improve the quality of care at home, with some even aiming to help patients avoid hospitalizations all together and receive advanced medical care at home.

Home health billing and coding can be complex with rules varying among private insurance companies, Medicare and Medicaid and unique documentation requirements. As the demand for home health care grows, outsourcing medical billing and coding to an experienced service provider can ensure accurate claim submission and reimbursement.