The home health industry reached a major legislative milestone on Thursday, with U.S. Sens. Debbie Stabenow (D-Mich.) and Todd Young (R-Ind.) teaming up to introduce a new bill to support in-home care alternatives to skilled nursing facilities (SNFs).
Endorsed by the AARP and supported by a long list of home-based care advocates, the Choose Home Care Act of 2021 has been gaining momentum on Capitol Hill over the past several months. If enacted, the legislation would enable certain Medicare patients to receive “extended care services” as an add-on to the existing Medicare home health benefit for 30 days following a hospital stay.
In addition to receiving skilled nursing or rehabilitation services from their home health provider, for example, a patient could potentially receive meals, non-emergency transportation, remote patient monitoring and more. The idea is to give today’s highly diversified in-home care providers more flexibility and financial support to keep at-risk Medicare beneficiaries at home and out of costlier facility-based settings, in turn saving the U.S. health care system hundreds of millions of dollars a year.
Co-sponsors of the newly introduced Choose Home bill include Sens. Ben Cardin (D-Md.), Susan Collins (R-Maine), Maggie Hassan (D-N.H.), James Lankford (R-Ohio), Bob Casey (D-Pa.) and Cynthia Lummis (R-Wyo.).
“This is a terrific, groundbreaking day. It recognizes that we have a Medicare home health benefit that could use modernizing,” Joanne Cunningham, executive director of the Partnership for Quality Home Healthcare (PQHH), told Home Health Care News. “Through the Choose Home proposal, hundreds of thousands of Medicare beneficiaries would have the option of going home and receiving home health care at a nursing home level. It’s very exciting, and it’s all about choice, safety and increasing health care options for Medicare beneficiaries in their homes.”
Strengthening the nation’s home- and community-based services (HCBS) infrastructure has become a priority for the Biden administration, but the support behind Choose Home also suggests lawmakers are clearly willing to reach across the aisle in order to reshape the post-acute care landscape, according to Cunningham.
“We have so many Republicans and Democrats who understand and value the opportunity to enhance at-home care options for Medicare beneficiaries,” she said. “Every time we’ve sat down with lawmakers of both political parties on this topic, the clear message back was, ‘Yes. We’re excited about this opportunity. We see the value in enhancing at-home care for more Medicare beneficiaries.’”
The National Association for Home Care & Hospice (NAHC), LeadingAge, Allies for Independence and Moving Health Home, the relatively new home care coalition whose founding members include Amazon Care and multiple health systems, are among the other organizations standing behind Choose Home. The National Council on Aging, the Council of State Home Care & Hospice Associations and the Forum of State Associations, a division of NAHC, support the bill as well.
“The Choose Home Care Act represents a tremendous step forward for Medicare beneficiaries who would prefer to recover at home, but have been previously prevented from doing so under current policy restrictions,” NAHC President William A. Dombi said in a press release.
Dombi first told HHCN that Choose Home was nearing a formal introduction back in June.
Along with meals and transportation benefits, a Choose Home-eligible patient could, if necessary, also receive care coordination and transition support, plus respite and training services for family caregivers.
An analysis from health economics firm Dobson DaVanzo & Associates found that the Choose Home model would generate as much as $247 million in annual savings to the Medicare system, with the bulk of that coming from averted SNF stays. If enacted, the model would lead to savings of up to $2.8 billion over 10 years, according to the analysis.
Based on their own data, home health providers expect the demand from patients and hospital partners would be so high for Choose Home, that the model may even lead to dramatically higher savings closer to $925 million a year.
As far as payment mechanics, Choose Home would create an add-on to a normally paid home health episode under the Patient-Driven Groupings Model (PDGM).
This is a developing story. Please check back later for additional information.
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