Referring to Home Health

How to refer to home health and the benefits for both patient and referring physician.

Study Finds 18 Million Americans Need Home Care

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Approximately 18 million adults age 65 and older in the U.S. require some assistance with activities of daily living, however, but as several recent studies continue to show, the number of available caregivers needed to accommodate this demand will be in short supply, reports Home Health Care News.

Nearly one-half of older adults—or 18 million people—had difficulty or received help with activities of daily living within a single month, according to a report from University of Michigan researchers based on 2011 National Health and Aging Trends Study of more than 8,000 Medicare enrollees.

Of these individuals, nearly three million received assistance with three or more self-care or mobility activities in settings other than nursing homes.

Nearly all older adults in settings other than nursing homes had at least one informal care network member, which the study defined as a family member or close friend.

Costs largely played a significant impact for these individuals, with about 3 in 10 receiving paid care and a disproportionate share of persons having low incomes.

Of those who had difficulty or received help in settings other than nursing homes, 32% had an adverse consequence in the last month related to an unmet need, whereas for community residents with a paid caregiver, the figure was nearly 60%.

“The older population—especially those with few economic resources—has substantial late-life care needs,” concludes the study’s authors. “Policies that improve long-term services and supports and reduce unmet need could benefit both older adults and those who care for them.”

Courtesy Home Health Care News


Study: Home Care Reduces Short-Term Readmissions

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Transitional care interventions from hospital to home reduced hospital readmissions for chronically ill patients in the intermediate term (31-180 days) and in the long term (181-365 days), according to a study in Health Affairs.

Home care visits a necessary tool in reducing short-term (30 days or less) hospital readmissions for chronically ill adults.

Home care visits a necessary tool in reducing short-term (30 days or less) hospital readmissions for chronically ill adults.

 

However, only high-intensity interventions — including home care — seemed to be effective in reducing short-term readmissions for chronically ill patients.

“Our findings suggest that to reduce short-term readmissions, transitional care should consist of high-intensity interventions that include care coordination by a nurse, communication between the primary care provider and the hospital and a home visit within three days after discharge,” the authors write.

Read study in Health Affairs.


Home Health for Patients with Pyschiatric Diagnoses

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The National Hospice and Palliative Care Organization is making it easier for families to search for hospice providers through a new resource tool.

The National Hospice and Palliative Care Organization is making it easier for families to search for hospice providers through a new resource tool.

Are your psychiatric patients driving up readmission numbers? Home health care may be an answer.

Medicare beneficiaries with severe mental illness (SMI) have complex health needs, often a co-occurring physical health condition, and utilize high volumes of services. In fact, Medicare spends five times more on beneficiaries with severe mental illness and substance abuse disorder than on similar beneficiaries without these diagnoses, reports the SCAN Foundation.

Often SMI affects a patient’s adherence to treatment plans, especially if those plans are from various medical providers across settings. The result? Exacerbations that require high-cost services.

The all-cause 30-day readmission rate for patients with schizophrenia and other psychotic conditions (and who have a primary expected payer of Medicare) is 23.7 percent, according to the Agency for Healthcare Research and Quality. Under all-cause 30-day readmissions, the readmission rate is 24.2 percent for personality disorders and 26 percent for screening and history of mental health and substance abuse.

How can home health care help?

Psychiatric diagnoses most likely qualify for Medicare home health. Home health care services integrate behavioral health with skilled nursing to positively impact quality, costs and outcomes. Psychiatric patients don’t have to adhere to the typical homebound criteria requirements.  Indeed, they may have no physical limitations and still qualify for home health care.

Homebound criteria applied to psychiatric patients:

*Illness is manifested by a refusal to leave the home (e.g., severe depression, paranoia, agoraphobia).

*Due to illness it would be unsafe for the patient to leave the home (e.g., hallucinations, violent outbursts).

*Patient is blind or senile and requires assistance in leaving the home (includes patient with dementia who the physician deems is unsafe to be outside of home without supervision).

Also, homebound status is NOT affected by frequent absences from the home to receive therapeutic, psychosocial or medical treatment that can’t be provided in the home (adult day care, group therapy, etc.).