The Key Problems with Medicare’s Home Health Profit


Home-based care services are an important element of medical care.

Despite this fact, issues surrounding accessibility have hindered the Medicare home health profit’s ability to be effective, a recent report published in Health Affairs Thursday suggests.

The report was authored by Henry J. Kaiser’s President Barbara Lyons, in addition to Diane Rowland, the previous executive vice chairman of and emerita of the muse.

For Medicare beneficiaries, access to home health services isn’t at all times a given. That is the case for quite a lot of reasons, in response to the report.

Sometimes, individuals who need and qualify for these services aren’t aware of them. Physicians not ordering home health services is one other factor, in addition to providers not at all times delivering required care.

Amongst home health providers, there is usually confusion about what is roofed and financial incentives on account of Medicare’s payment systems, quality measures and audit systems, in response to the report.

Plus, there are challenges around hospitals making referrals to home health providers.

“Even a referral upon hospital discharge for Medicare home health advantages is just not sufficient, with disparities by race, ethnicity and residence ZIP code,” the authors wrote within the report.

The authors suggest that the federal government should beef up the standard and transparency of public program data by race, ethnicity, language, age, disability status and residence for home health referrals.

“Such efforts are crucial to look at and eliminate disparities in access to home health services and to carry providers accountable,” the authors wrote. “To raised understand how racism and culture affect access and use of home health services, federal officials should put money into research and community partnerships to have interaction and work with diverse communities of Medicare beneficiaries, their caregivers and the providers anchored in these communities.”

With regards to upholding home-based care services, Medicaid might be a very good model to follow for Medicare, in response to the authors.

“Over the past 20 years, Medicaid has prioritized access to home and community-based service,s including personal care services,” they wrote. “Key strategies that support equitable access to in-home services include centering the beneficiary in decision making, systematic referral and provision of services, eliminating conflicts in payment incentives, and a reasonably compensated direct care workforce.”

The U.S. Centers for Medicare and Medicaid Services’ (CMS) effort to integrate look after dual-eligible beneficiaries will make room for the Medicare home health profit to function a complement to Medicaid’s service package, in response to the report.

The report highlights the necessity to make clear Medicare’s home health advantages policy.

“Policymakers must make sure that federal policy and regulatory practices align with current law, driving provider actions to supply the total range of services, not only expert care,” the authors wrote.

Understanding Medicare policy will develop into increasingly vital with the upcoming nationwide expansion Home Health Value-Based Purchasing (HHVBP) Model.

Finally, the report also urges Congress to research the roadblocks that beneficiaries face when attempting to utilize the Medicare home health profit.


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