Unbiased Analysis of Today's Healthcare Issues

Archive for the 'Home Health' Category

The cost of Informal Elder Care

Many adults spend significant time caring for sick, elderly parents.  What is the cost of providing this informal care?  Would it be better to have family members outsource the care to formal caregivers? A paper by Chari, Engberg, Ray and Mehrotra (2014) attempt to answer this question.  They use data from the  American Time Use Survey […]

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History of Medicare Home Health Payments

Medicare pays home health agencies (HHAs) to care for patients who cannot care for themselves in their own homes.  HHAs, however, have experienced significant changes in the way Medicare pays them over the past 30 years.  A recent paper by Huckfeldt et al. (2014) summarizes these changes: 1983: Medicare switches to an inpatient prospective payment […]

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100% Nursing Home Occupancy Rate in Singapore

Aging adults with additional functional need typically are either cared for in one of two settings: i) the home, or ii) a nursing home.  Singapore’s policy greatly favors the former. In contrast with the United Kingdom and the United States, Singapore has sought to minimize LTC costs by adopting an LTC policy that promotes “the […]

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Does Competition Improve Quality?

For the most part, the answer is “Yes” according to a recent study by Jung and Polsky.  The authors use a Herfindahl index to measure competition and examine how outcomes for home health patients vary based on the level of competition.  The (unadjusted) figures–based on data from OASIS– show that quality increases as competitions increases […]

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Long Term Care in the 13th Century

There have been a number of recent efforts to finance long-term care for the elderly. The health reform law, as amended by the Health Care and Education Reconciliation Act of 2010, created a national, voluntary insurance program for purchasing community living services and supports known as the Community Living Assistance Services and Supports program (CLASS […]

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Medicare Reimbursement for Outpatient Therapy

Today I review Medicare’s approach for paying for outpatient therapy visits. The content draws largely from CMS and MedPAC sources. What is outpatient therapy Outpatient therapy includes physical therapy (PT), occupational therapy (OT), and speech-language pathology (SLP) services. Who can provide outpatient therapy? Institutional Facilities Hospitals Skilled nursing facilities (SNF) Comprehensive outpatient rehabilitation facilities (CORF) […]

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Expanision of Medicare Home Health Entitlement

Healthcare spending in the U.S. has been rising by 6.6%per year between 1990 and 2010.  Over this same time period, however, home health spending increased by 9.0% per year.  Do rising home health cost represent an increase in access to needed care or a costly expansion of heallth care benefits?  Or, is this just a […]

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Physicians: Coming to a Home Near You

In the 18th and early 19th centuries, physician home visits in the U.S. were very common.  In fact, the home was the primary place where medicine was practiced.  Because physician wages at this time were comparable to those of the average laborer, a market which forced physicians to internalize the time and transportation costs to […]

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The President’s Proposal to “Live Within Our Means”

President Obama released a proposal last week to jump start the economy and reduce the deficit.  The proposal includes many cuts to Medicare and increased cost sharing.  Senators Coburn and Lieberman are supporting these cuts. Increased cost sharing is a common theme in Medicare, Medicaid, but also for other programs as well.  For instance, the […]

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MedPAC’s Home Health Recommendations

In their latest 2011, MedPAC made four recommendations to alter payment policy in the home health setting.  These include the following: The Secretary, with the Office of Inspector General, should conduct medical review activities in counties that have aberrant home health utilization.  The Secretary should implement the new authorities to suspend payment and the enrollment […]

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