Home healthcare services may be cheaper, more accessible, and just as effective than hospitalization. Check with your Medicare health plan to discover how you can access home health services.
Home healthcare workers have recently launched a campaign to secure better pay after two appellate court rulings determined they must receive minimum wage for 24-hour shifts, which include sleep time.
Supportive Services
Patients suffering from chronic diseases like heart failure, AIDS or cancer require home healthcare services for monitoring and medication management. This care allows them to remain in their familiar homes surrounded by loved ones, familiar places of worship and community support networks.
Medical home health care services are typically provided by nurses, therapists and other trained personnel, such as nurses or therapists. Services typically provided include wound care, injections and physical, occupational and speech therapy – according to Yount. Non-medical home health care entails assistance with daily tasks like bathing/dressing assistance meal prep/planning as well as transportation needs when necessary for doctor appointments or shopping excursions.
Home health agencies must comply with both state and federal regulations that may differ depending on where they operate. Some private health plans cover home healthcare as do Medicare and Medicaid; both reimburse certified home healthcare agencies that offer intermittent visits at reduced costs while helping reduce unplanned hospital visits. Many states offer long term care insurance that can be purchased privately from various providers.
Skilled Services
Home health care services are provided by trained medical professionals such as nurses and physical therapists. Medical home healthcare providers assist physicians in treating various medical issues prescribed to them such as wound care, medication management and monitoring chronic conditions; additionally they also offer education, counseling and support services for both their patients and families.
Home healthcare agencies also offer home health aide services to assist patients in daily activities such as bathing, grooming and meal preparation. Home healthcare agencies work towards reducing avoidable hospital readmissions through providing education on proper home health services as well as contracting home healthcare aides independently or contracting one through an agency.
Home health care allows individuals to receive medical assistance in the comfort and familiarity of their own homes, close to family and friends. Home healthcare may be less costly, more convenient, and just as effective than hospitalization or skilled nursing facilities – typically covered at least partially by Medicare as well as private insurers or long-term care insurance plans.
Medicare Coverage
Medicare covers home health care provided by an agency certified with Medicare if you meet certain criteria:
Your condition requires you to leave your house with considerable effort, possibly using a wheelchair or walker, so a doctor or other practitioner must visit and confirm your need for home healthcare.
Your care plan must be written and reviewed regularly by a doctor or qualified practitioner, meet the Medicare deductible for durable medical equipment and pay 20% of Medicare-approved amounts for home healthcare services after you’ve met this threshold. Depending on the type of home health care, additional Medicare criteria may need to be fulfilled depending on its nature; an agency cannot deny, restrict, limit, or cut back your care without providing an Advance Beneficiary Notice (ABN), explaining why some care may require payment and which services may not be covered – these notices must contain information regarding potential alterations that might require payment as well as services that might not covered under Medicare coverage criteria.
Laws and Regulations
Home health agencies must comply with federal and state laws, regulations and policies; therefore they must implement an efficient legislative tracking process as well as proactive compliance strategies in order to remain compliant with new laws and regulations.
CHHAs must ensure that physicians or other non-physician practitioners certifying medical necessity of home health services do not work or contract for themselves with their home health agency, and prior authorizations must be signed off by attending physicians or qualified non-physician practitioners who have seen the member within 60 days.
If the CHHA determines that a member can be adequately and cost-effectively served by other home healthcare or long term care services in their social services district, they must document this decision in the plan of care or medical notes and notify both recipient and physician accordingly. Subsequently, an in-person meeting between recipient’s physician and CHHA must occur to discuss reduction of services; minutes from this meeting must also be recorded by CHHA.