about Traditional Home Health Agencies
Although most home care is provided by family, friends or volunteers, there is a growing trend to hire paid individuals or professionals to provide this care in the home. The hiring of care is prompted by a growing trend for traditional caregivers to be employed full-time and unable to offer much help or for family to live hundreds of miles away from the loved one and find it difficult to offer hands-on long-distance care.
In the year 2000, about 12,800 home health agencies served approximately 8,600,000 clients across the United States . In that year Medicare paid an estimated 85% to 90% of the total cost of home health agency services amounting to $ 8,700,000,000. Although current figures are not yet available, the number of home health agencies has been going up year after year as well as the number of clients being served.
Although home health agencies are privately owned, Medicare is the principle payer for their services. Home health services through Medicare are available under parts A and B. In order to qualify for Medicare homecare a person must have a skilled need, must be homebound and there must be a plan of care ordered by a Physician.
Prior to 1997 Medicare typically paid for home care for as long as it was needed. Prior to 1997 annual Medicare costs were almost double the amount cited above. In order to save money Medicare has since gone to a prospective payment system where, according to the plan of care, a certain amount of money is allocated to resolve the skilled need for the patient.
Monies are typically provided for a period of up to 60 days. If the patient recovers sooner then money may have to be reshuffled to other patients who are not responding as well. If the patient needs more than 60 days to recover, additional monies are available. At the point where the patient does not respond or improve, no more Medicare money is forthcoming. After Medicare cuts off, a person continuing to need long-term care services must find sources other than Medicare.
Home health agencies deliver a variety of skilled services. The plan of care usually includes custodial services to help the care-recipient remain in the home. These would include an aide for an hour or two a day to help with bathing, dressing and transferring. If there is time remaining other personal services may be offered as well.
Recently Medicare has redefined what it means by "homebound" to allow recipients to leave the home on a limited basis. Under the new definition, Medicare will also allow and pay for home visits from doctors who specialize in homebound elderly patients. Limited office visits are also allowed under the new definition. Finally, in the past few years Medicare is paying for home telehealth visits through a home telehealth, computer work station. Telehealth is being used with some success to provide home care in rural areas where it would be difficult to arrange the personal visit from a home health care agency.