When it comes to Home Health care it seems like it’s becoming harder for those to obtain as of January 1st. This problem has to do with how Medicare pays for services home health services. From the cutting of physical, occupational and speech therapy for patients to firing therapists, agencies are stating Medicare no longer covers certain services. With home care agencies providing care to 3.4 million Medicare beneficiaries this change might be detrimental to those in need of these specific services.
What Is Home Health Services?
Home Health services are covered by Medicare Part A & B. Services available to those eligible include:
- Physical therapy
- Occupational therapy
- Speech-language pathology services
- Medical social services
New Home Health Service Regulations
Previously, home health rates reflected the amount of therapy delivered. Now, therapy isn’t explicitly factored into Medicare’s reimbursement system, Patient-Driven Groupings Model. Payments are being based on patients underlying diagnosis. This includes medical conditions that might cause the person to be impaired, whether or not they are referred to services after hospitalization or rehabilitation center. It also pertains to the extent of services needing to be provided. There is also a stronger financial incentive to help those who need short term therapy after a release from one of the facilities stated Kathleen Holt, associate director of the Center for Medicare Advocacy. Compared to the fewer incentives to help those who need extensive physical, occupational and speech therapy.
Studies Show
This system is to encourage a holistic assessment of a patient’s needs. Convincing evidence shows that at times health agencies provide too much therapy under Medicare’s previous system according to Jason Falvey, a postdoctoral research fellow in the geriatrics division at Yale School of Medicine. According to a report from the National Association for Home Care and Hospice last fall, they asked how practices would change under the PDGM. One-third stated they were going to reduce therapy services. It is important to understand that most home care agencies are for-profit, which can be a reason for certain decisions.
What do you think of the new home health service practices? Do you believe home health therapy will decrease? Leave a comment below and tell us your thoughts!
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