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 [...]
Read the rest of this entry »Archive for the 'Home Health' Category
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 [...]
Read the rest of this entry »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) [...]
Read the rest of this entry »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 [...]
Read the rest of this entry »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 [...]
Read the rest of this entry »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 [...]
Read the rest of this entry »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 [...]
Read the rest of this entry »Can Home Health Care Reduce Cost?
At one point, the answer may have been yes. But today… “Although the initial impetus for establishing home health care was charitable, the Metropolitan Life Insurance Company (MetLife) discovered that by providing home health care, it could prolong life while collecting premiums and abstaining from death benefit payments. Yet the model experienced a requisite shift [...]
Read the rest of this entry »MedPAC’s 2011 Home Health Reform Recommendations
In 2009, 3.3 million Medicare beneficiaries used home health. In the past few years, the home health expenditure growth rate has outpaced Medicare spending in all other areas. This finding is likely correlated with the 9.7% increase in the number of home health agencies between 2008 and 2009. How should Medicare reform home health to [...]
Read the rest of this entry »The History of Home Health Quality Measurement
Today I will discuss the evolution of home health care measures over the past 15 years. The majority of the content comes from an article by Robert Rosati (2009). Timeline Here is a link to a TIMELINE that briefly summarizes the key developments in home health care quality measurements. Risk Adjustment From the early development [...]
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